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Lookup NU author(s): Dr Charlie Tomson
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© The Author 2016. 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.
Author(s): 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
Publication type: Article
Publication status: Published
Journal: Nephrology Dialysis Transplantation
Year: 2017
Volume: 32
Issue: 5
Pages: 890-900
Online publication date: 31/03/2017
Acceptance date: 09/02/2017
Date deposited: 27/06/2017
ISSN (print): 0931-0509
ISSN (electronic): 1460-2385
Publisher: Oxford University Press
URL: https://doi.org/10.1093/ndt/gfx036
DOI: 10.1093/ndt/gfx036
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