For a study, researchers sought to develop a study to create a scalable metric that measures kidney transplant (KT) facilities’ effectiveness in providing equal access to KT for minority patients, based on each patient’s unique prelisting prevalence of end-stage renal disease (ESRD). The differences in care provided by different KT facilities were unknown, despite the fact that racial and ethnic discrepancies in access to transplants in patients with ESRD were well documented. Furthermore, there was no system in place to measure how effectively a KT facility gives ESRD patients of color fair access to KT. The Kidney Transplant Equity Index (KTEI), which measured the proportion of minorities receiving kidney transplants in a center in relation to the prevalence of minorities with ESRD in each center’s service area, was calculated between 2013 and 2018 using unique datasets from the United States Renal Data System and United Network for Organ Sharing. Comparing high and poor KTEI centers using socioeconomic level indicators and beneficiary outcomes. In comparison to the 475,914 ESRD patients who were not transplanted, a total of 249 transplant facilities conducted 111,959 KTs. For Black (105.5 vs. 24, P<0.001), Hispanic (55.5 vs. 7, P<0.001), and American Indian (1.0 vs. 0.0, P<0.001) patients, high KTEI centers performed more KTs than low KTEI centers did. Additionally, patients at high KTEI facilities had transplants at higher rates of unemployment (52 vs. 44, P<0.001), socioeconomic deprivation (53 vs. 46, P<0.001), and educational achievement (52 vs. 43, P<0.001). High KTEI centers improved patient survival (hazard ratio: 0.86, 95% CI: 0.77-0.95) while facilitating greater access to transplants for populations of color and lower socioeconomic status. The KTEI is the first statistic to quantify minority access to KT using the prelisting ESRD prevalence specific to transplant facilities. Through KTEIs, extremely equitable centers were found, and significant nationwide variation in transplant procedures was uncovered. For minority and poor socioeconomic individuals with ESRD, this innovative metric should be used to spread best practices.

 

Source: journals.lww.com/annalsofsurgery/Abstract/2022/09000/The_Kidney_Transplant_Equity_Index__Improving.2.aspx