Session Name: Non-Organ Specific: Public Policy & Allocation
Session Date & Time: None. Available on demand.
*Purpose: Simultaneous kidney and pancreas transplantation(SPK) provides a survival and quality of life advantage in young, low BMI insulin dependent diabetics with End Stage Renal Disease (IDDMesrd). Because of secondary complications such as retinopathy, many are disabled and unable meet eligibility for Medicare coverage. The greater Los Angeles metropolitan area has had no active pancreas transplant program for Medi-cal patients (CA’s Medicaid) with the nearest one contracted in San Francisco. The purpose of our study was to compare the transplant rate and waitlist mortality in diabetics under 50 years of age based on their insurance status.
*Methods: IDDMesrd patients referred to our center and medically eligible for SPK were analyzed in this study. Following were the inclusion criteria ; Age < 50 years, Insurance status : Medi- cal or Medi-care. Other form of insurances were not included in this study. The following data was collected: waitlist mortality (both active and active on the list) , transplant rate and type of transplant.
*Results: There were 129 patients that met the eligibility criteria- 47 Medi-Cal and 82 MedicareWaitlist mortality for Medi-cal was 10/47 (21%) , 0 patients received a SPK and 5/47 (10%) received a kidney transplant alone. Waitlist mortality for the Medicare group 11/82(13%) ,16/82 (20%) received a SPK.
*Conclusions: In our single center analysis of young IDDMesrd ineligible for a SPK due to insurance, the waitlist mortality was almost double and transplant rate half when compared to individuals that were insurance eligible. The higher transplant rate in the Medicare group is likely the result of shorter wait times for SPK compared to kidney alone in the Los Angeles area. Young Medi-Cal IDDMesrd patients in the greater Los Angeles area that are unable to be to be listed for SPK locally due to insurance, are significantly disadvantaged and suffer higher mortality and lower transplant rates. There is an urgent need for Med-ical to provide more local access for SPK in the greater Los Angeles area.
To cite this abstract in AMA style:Qazi YA, Villalon E, Samson D, Mon W, Smogorzewski M. The Impact of Lack of Access to Simultaneous Kidney and Pancreas Transplantation Due to Insurance Ineligibility – A Single Center Analysis [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/the-impact-of-lack-of-access-to-simultaneous-kidney-and-pancreas-transplantation-due-to-insurance-ineligibility-a-single-center-analysis/. Accessed June 12, 2021.
« Back to 2021 American Transplant Congress