Why hemodialysis patients fail to complete the transplantation process

G. Alexander, Ashwini R. Sehgal

Research output: Contribution to journalArticle

Abstract

The cadaveric renal transplantation process involves steps related to medical suitability, interest in transplantation, pretransplantation workup, and movement up a waiting list. Failure to complete specific steps may be caused by remaining stationary at that step, moving backward to a previous step, or dying. Knowing the relative importance of these types of movement may enable the development of strategies that improve the efficiency and equity of the transplantation process. We examined 4, 597 new dialysis patients to determine the likelihood of remaining stationary, moving backward, or dying at each of the following steps: (A) being medically suitable and possibly interested in transplantation, (B) being definitely interested, (C) completing the pretransplantation workup, and (D) moving up a waiting list and receiving a transplant. Failure to complete a step was generally caused by remaining stationary rather than moving backward or dying. The likelihood of remaining stationary ranged from 78% at step A to 90% at step D. The likelihood of backward movement ranged from 3% to 7%, whereas the likelihood of death ranged from 7% to 22%. Compared with whites, blacks were more likely to remain stationary at steps A (odds ratio [OR], 1.96) and B (OR, 1.52), more likely to move backward at step B (OR, 1.79), and less likely to die at steps A through C (ORs, 0.45 to 0.60). In conclusion, failure to move through the transplantation process is usually caused by remaining stationary at specific steps rather than moving backward or dying. The relative importance of these types of movement differs among blacks and whites.

Original languageEnglish (US)
Pages (from-to)321-328
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume37
Issue number2
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

Keywords

  • Access to health care
  • Dialysis
  • End-stage renal disease (ESRD)
  • Kidney transplantation

ASJC Scopus subject areas

  • Nephrology

Fingerprint Dive into the research topics of 'Why hemodialysis patients fail to complete the transplantation process'. Together they form a unique fingerprint.

  • Cite this