Geographic inequity in transplant access
Raymond J Lynch1,2, Rachel E Patzer1,2,3
1Division of Transplantation, Department of Surgery.
Current Opinion in Organ Transplantation
|May 16, 2019
Summary
Geographic inequities persist in organ transplantation access, particularly for kidney transplants, despite policy changes. Further research is needed to understand barriers for all eligible patients, not just those waitlisted.
Area of Science:
- Transplantation Medicine
- Health Policy
- Organ Allocation
Background:
- Chronic donor organ shortages create a challenging transplant landscape.
- Geographic disparities in patient access to lifesaving organs are a significant concern.
- Recent policy shifts aim to address unequal organ supply and demand.
Purpose of the Study:
- To review recent literature on geographic inequities in transplant access.
- To focus on kidney, liver, and lung transplantation.
- To examine the impact of policy changes on organ allocation.
Main Methods:
- Literature review of recent studies on geographic disparities in transplantation.
- Analysis of policy changes impacting organ allocation.
- Focus on kidney, liver, and lung transplant access.
Main Results:
- Geographic inequity in kidney transplant access persists despite the 2014 policy change.
- Liver transplant access debates focus on acuity scores, with emerging research on broader disparities.
- Undeniable geographic differences exist in transplant care access and quality.
Conclusions:
- Existing metrics for transplant disparities are limited to waitlisted candidates.
- Future research must explore barriers for transplant-eligible patients not on waiting lists.
- Addressing geographic inequities requires a comprehensive understanding of access barriers.
Related Concept Videos
01:25Selected Data About Geographic Locations
265
Geographic Information Systems (GIS) rely on two core types of data: spatial data and attribute data.Spatial DataSpatial data defines the physical location of features within a coordinate system, typically expressed in terms of latitude and longitude. It provides precise positioning for elements like roads, rivers, or buildings.Attribute DataAttribute data complements spatial data by adding descriptive information about these features. For example, a road's spatial data includes its start and...
265
01:24Tissue Transplantation
945
Tissue transplantation is a significant medical procedure involving the transfer of cells, tissues, or organs from a donor to a recipient, with the primary aim of restoring lost functions. This procedure is crucial in treating a broad spectrum of diseases, including kidney diseases, liver failure, heart disease, and certain types of cancers.
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
The Biology of Tissue Transplantation
The biology of tissue transplantation hinges on the Major Histocompatibility Complex (MHC) molecules. These molecules...
945
01:28Kidney Transplant I: Introduction
375
A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
375
01:22Bone Marrow Sampling and Transplants
973
Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
973
01:26Kidney Transplant II: Surgical Procedure
370
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
370
01:16Kidney Transplant III: Nursing Management
349
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
349