Access to kidney transplantation: the limitations of our current understanding.
Since kidney transplantation (KTX) is the preferred means of treating kidney failure, ensuring that all patients who may benefit from KTX have equal access to this scarce resource is an important objective. Studies focusing on this issue will become increasingly important as the gap between the demand and supply of organs continues to increase, and changes to the United Network of Organ Sharing organ allocation policy are actively debated. However, it is clear that current methods used to study access to KTX have serious limitations. This review highlights the shortcomings of the methods currently used to assess access to KTX, and the limitations of registry data and national wait-list data as information sources to study patient access to KTX. The review also provides suggestions for research and analytical approaches that might be utilized to improve our future understanding of patient access to KTX. The information provided will aid the reader to critically assess issues related to patient access to KTX.
Gill
John S
JS
Division of Nephrology, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia - Canada. jgill@providencehealth.bc.ca
Johnston
Olwyn
O
D002170:Canada / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006302:Health Services Research / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D019520:Living Donors; D018579:Patient Selection; D012042:Registries; D051437:Renal Insufficiency / Q000453:epidemiology / Q000601:surgery*; D012111:Residence Characteristics; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014850:Waiting Lists