Major inequalities in access to kidney transplant waiting list revealed

November 27, 2003

Major inequalities exist in access to the kidney (renal) transplant waiting list and renal transplantation in Scotland, finds a study in this week's BMJ. These inequalities may also exist elsewhere in the United Kingdom.

Researchers identified 4,523 adults starting renal replacement therapy in Scotland between January 1989 and December 1999. They followed them to placement on the waiting list, transplantation, death, or end of the study (31 December 2000).

A total of 1,736 (38%) of patients were placed on the waiting list for renal transplantation and 1,095 (24%) underwent transplantation during the study period.

Patients were less likely to be placed on the list if they were female, older, had diabetes, were socially deprived, or were treated in a hospital with no transplant unit. Patients living furthest away from the transplant centre were listed more quickly.

This is the first time that inequalities in access to the renal transplant waiting list have been identified in this way in the United Kingdom, say the authors.

These inequalities may also exist elsewhere in the United Kingdom because of similarities in the management of patients with end stage renal failure, referral patterns for transplantation, and the transplantation process, they conclude.
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BMJ

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