title: UK Renal Registry 15th annual report: Chapter 9 centre variation in access to renal transplantation in the UK (2006-2008).
abstract: BACKGROUND
  Renal transplantation is recognised as being the optimal treatment modality for many patients with established renal failure. This analysis aimed to explore inter-centre variation in access to renal transplantation in the UK.
  
  
  METHODS
  Transplant activity and waiting list data were obtained from NHS Blood and Transplant, demographic and laboratory data were obtained from the UK Renal Registry. All incident RRT patients starting treatment between 1st January 2006 and 31st December 2008 from 72 renal centres were considered for inclusion. The cohort was followed until 31st December 2010 (or until transplantation or death, whichever was earliest).
  
  
  RESULTS
  Age, ethnicity and primary renal diagnosis were associated with both accessing the kidney transplant waiting list and receiving a kidney transplant. A patient starting dialysis in a non-transplanting renal centre was less likely to be registered for transplantation (OR 0.80, 95% CI 0.74-0.87) or receive a transplant from a donor after cardiac death or a living kidney donor (OR 0.69, 95% CI 0.61-0.77) compared with patients cared for in transplanting renal centres. Once registered for kidney transplantation, patients in both transplanting and non-transplanting renal centres had an equal chance of receiving a transplant from a donor after brainstem death (OR 0.92, 95% CI 0.79-1.08).
  
  
  CONCLUSIONS
  There was wide variation in access to kidney transplantation between UK renal centres which cannot be explained by differences in case mix.
authors.affiliation: UK Renal Registry, Bristol, UK. renalregistry@renalregistry.nhs.uk
authors.forename: Rishi
authors.initials: R
authors.lastname: Pruthi
authors.forename: Rommel
authors.initials: R
authors.lastname: Ravanan
authors.forename: John
authors.initials: J
authors.lastname: O'Neill
authors.forename: Paul
authors.initials: P
authors.lastname: Roderick
authors.forename: Laura
authors.initials: L
authors.lastname: Pankhurst
authors.forename: Udaya
authors.initials: U
authors.lastname: Udayaraj
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000847:Annual Reports as Topic; D003131:Combined Modality Therapy; D005260:Female; D015276:Health Care Rationing / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000628:therapy*; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000706:statistics & numerical data / Q000639:trends; D015995:Prevalence; D012042:Registries; D006435:Renal Dialysis / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D062206:Spatial Analysis; D006113:United Kingdom / Q000453:epidemiology; D014850:Waiting Lists; D055815:Young Adult