Referral for Kidney Transplantation in Canadian Provinces

Journal of the American Society of Nephrology : JASN
S Joseph KimBryce Kiberd

Abstract

Patient referral to a transplant facility, a prerequisite for dialysis-treated patients to access kidney transplantation in Canada, is a subjective process that is not recorded in national dialysis or transplant registries. Patients who may benefit from transplant may not be referred. In this observational study, we prospectively identified referrals for kidney transplant in adult patients between June 2010 and May 2013 in 12 transplant centers, and linked these data to information on incident dialysis patients in a national registry. Among 13,184 patients initiating chronic dialysis, the cumulative incidence of referral for transplant was 17.3%, 24.0%, and 26.8% at 1, 2, and 3 years after dialysis initiation, respectively; the rate of transplant referral was 15.8 per 100 patient-years (95% confidence interval, 15.1 to 16.4). Transplant referral varied more than three-fold between provinces, but it was not associated with the rate of deceased organ donation or median waiting time for transplant in individual provinces. In a multivariable model, factors associated with a lower likelihood of referral included older patient age, female sex, diabetes-related ESKD, higher comorbid disease burden, longer durations (>12.0 months) of p...Continue Reading

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Citations

Jan 21, 2020·Seminars in Dialysis·Rachel E Patzer, Stephen O Pastan
Jun 11, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Anne M HumlJesse D Schold
May 16, 2020·Nursing Ethics·Rajah RasiahHamid Sharif Nia
Sep 1, 2019·Journal of the American Society of Nephrology : JASN·Rachel E Patzer, Laura McPherson
Jan 26, 2020·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Rachel E PatzerStephen O Pastan
May 14, 2021·Kidney International Supplements·Aminu K BelloUNKNOWN ISN North America and the Caribbean Regional Board
Jun 19, 2021·Journal of the American Society of Nephrology : JASN·John S GillNeil R Powe

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