Distance No Bar to Kidney Transplants in Remote Areas

Finding contradicts belief that process favors people in urban areas

HealthDay
By Robert Preidt
Tuesday, April 21, 2009

TUESDAY, April 21 (HealthDay News) -- People with kidney failure who live in rural or remote areas are not less likely to get a kidney transplant than people in urban areas, a new study finds.
Researchers analyzed U.S. data on 699,751 adults with kidney failure who were placed on a kidney transplant list between 1995 and 2007. After about two years on the list, 122,785 (17.5 percent) of them had received a transplant. Median distance to the closest transplant center was 15 miles.

In contrast to their pre-study theory that people who lived farthest from a transplant center were less likely to get a transplant, "the likelihood of receiving a kidney transplant from a deceased or living donor among patients living farther away was similar to or greater than those residing within 15 miles of kidney transplant centers," the study authors wrote. "Similarly, and again in contrast to our hypotheses, the adjusted likelihood of kidney transplant was slightly lower among rural dwellers."

The study is in this week's issue of the Journal of the American Medical Association.
"Although unexpected, our findings are encouraging because determining eligibility for kidney transplantation is a logistically challenging process that requires sequential diagnostic tests and encounters with health-care clinicians," wrote Dr. Marcello Tonelli, of the University of Alberta, Edmonton, Canada, and colleagues. "The finding that time to transplantation is similar or even shorter among remote- and rural-dwelling patients with kidney failure suggests that disparities in access for remote- and rural-dwellers with other diseases could be reduced or eliminated."
"These data suggest that efforts to improve equitable access to transplantation should not focus on populations defined solely by residence location," the researchers concluded.