Transplant Center Distance No Factor in Kidney Transplant

Patients in rural areas are as likely to get a kidney as those in metropolitan areas, study finds
By Jeff Muise
HealthDay Reporter

TUESDAY, April 21 (HealthDay News) -- Living in a rural area or far from a kidney transplant center does not significantly affect a patient's chances of getting a transplant, according to a study in the April 22/29 issue of the Journal of the American Medical Association.

Marcello Tonelli, M.D., of the University of Alberta in Edmonton, Canada, and colleagues studied 699,751 patients with kidney failure in the United States from 1995 to 2007 to determine if living in a rural area or at a distance from a transplant center was associated with access to transplantation. Time to placement on the transplant waiting list and time to transplantation were measured, and hazard ratios were calculated with reference to patients closest to a transplant center.

In follow-up (median, two years), 122,785 patients had received a transplant. The hazard ratios (HR) for transplant for different distance categories, with zero to 15 miles as the referent category, were: 16 to 50 miles, HR = 1.03; 51 to 100 miles, HR = 1.11; 101 to 136 miles, HR = 1.14; 137 to 231 miles, HR = 1.16; 232 to 310 miles, HR = 1.20; and greater than 310 miles, HR = 1.16. Comparing micropolitan and rural areas to metropolitan (referent) areas, the hazard ratios were 1.13 and 1.15, respectively.

"In conclusion, we found no evidence that the likelihood of kidney transplantation was lower among remote- or rural-dwelling patients treated for kidney failure in the United States," the authors write. "These data suggest that efforts to improve equitable access to transplantation should not focus on populations defined solely by residence location."

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