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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Nephrol+Dial+Transplant
2017 ; 32
(5
): 890-900
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Barriers to living donor kidney transplantation in the United Kingdom: a national
observational study
#MMPMID28379431
Wu DA
; Robb ML
; Watson CJE
; Forsythe JLR
; Tomson CRV
; Cairns J
; Roderick P
; Johnson RJ
; Ravanan R
; Fogarty D
; Bradley C
; Gibbons A
; Metcalfe W
; Draper H
; Bradley AJ
; Oniscu GC
Nephrol Dial Transplant
2017[May]; 32
(5
): 890-900
PMID28379431
show ga
BACKGROUND: Living donor kidney transplantation (LDKT) provides more timely
access to transplantation and better clinical outcomes than deceased donor kidney
transplantation (DDKT). This study investigated disparities in the utilization of
LDKT in the UK. METHODS: A total of 2055 adults undergoing kidney transplantation
between November 2011 and March 2013 were prospectively recruited from all 23 UK
transplant centres as part of the Access to Transplantation and Transplant
Outcome Measures (ATTOM) study. Recipient variables independently associated with
receipt of LDKT versus DDKT were identified. RESULTS: Of the 2055 patients, 807
(39.3%) received LDKT and 1248 (60.7%) received DDKT. Multivariable modelling
demonstrated a significant reduction in the likelihood of LDKT for older age
{odds ratio [OR] 0.11 [95% confidence interval (CI) 0.08-0.17], P?0.0001 for
65-75 years versus 18-34 years}; Asian ethnicity [OR 0.55 (95% CI 0.39-0.77),
P?=?0.0006 versus White]; Black ethnicity [OR 0.64 (95% CI 0.42-0.99), P?=?0.047
versus White]; divorced, separated or widowed [OR 0.63 (95% CI 0.46-0.88),
P?=?0.030 versus married]; no qualifications [OR 0.55 (95% CI 0.42-0.74),
P?0.0001 versus higher education qualifications]; no car ownership [OR 0.51
(95% CI 0.37-0.72), P?=?0.0001] and no home ownership [OR 0.65 (95% CI
0.85-0.79), P?=?0.002]. The odds of LDKT varied significantly between countries
in the UK. CONCLUSIONS: Among patients undergoing kidney transplantation in the
UK, there are significant age, ethnic, socio-economic and geographic disparities
in the utilization of LDKT. Further work is needed to explore the potential for
targeted interventions to improve equity in living donor transplantation.