RESEARCH & EDUCATION
RESEARCH & EDUCATION
EXPLORING DISPARITIES IN ORGAN ALLOCATION AND ACCESS TO CARE
Investigators with the UAB Comprehensive Transplant Institute ( CTI ) have undertaken important research on the disparities that plague the nation ’ s organ transplant system , especially in renal transplantation , and they hope that their findings lead to change and better access to care .
One such study was published in July 2022 in the Annals of Surgery , titled “ Perpetuating Disparity : Failure of the Kidney Transplant System to Provide the Most Kidney Transplants to Communities with the Greatest Need ”. Authored by CTI Director Jayme Locke , MD , MPH , and seven other CTI investigators , the publication highlights research supported by R01 and K08 funding .
According to the study , regions of the United States with the highest rates of end-stage kidney disease ( ESKD ) also have the lowest rates of kidney transplantation ( KT ). At the same time , these regions have the poorest overall community health outcomes . The study examined the mismatch between ESKD burden and kidney transplant rates from a perspective of spatial epidemiology . It used U . S . Renal Data System data from 2015 to 2017 , and clustering of ESKD burden and KT rates at the county level were determined and correlated to county health scores ( CHS ). Higher-percentile CHS indicated worse overall community health .
“ Significant clusters of high ESKD burden tended to coincide with clusters of low KT rates , and vice versa ,” the study concluded . “ There is a significant mismatch between kidney transplant rates and ESKD burden , where areas with the greatest need have the lowest transplant rates . This pattern exacerbates pre-existing disparities , because disadvantaged , high-ESKD regions already suffer from worse access to care and overall community health , as evidenced by the highest CHS scores in the study . The sources of this disparity go beyond simple changes to organ allocation and will require multifactorial population health approaches to adequately address .”
Study co-author Robert Cannon , an assistant professor in the UAB Division of Transplantation , says he hopes this study and others like it lead to a more equitable system and improvements in population health .
“ In the past , we looked at it in terms of our responsibility starting and ending with the waitlist , but our actual responsibility starts before that , trying to get people to the waitlist in the first place and advocating for policy changes and better access to care ,” Dr . Cannon says .
16 UAB CTI Report