دورية أكاديمية
أعرض في EDS

Age Disparities in Access to First and Repeat Kidney Transplantation.

التفاصيل البيبلوغرافية
العنوان: Age Disparities in Access to First and Repeat Kidney Transplantation.
المؤلفون: Chen Y; Department of Surgery, New York University Grossman School of Medicine and New York University Langone Health, New York, NY., Churilla B; Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD., Ahn JB; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD., Quint EE; Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands., Sandal S; Division of Nephrology, Department of Medicine, McGill University Health Centre, Montreal, QC, Canada.; Research Institute of the McGill University Health Centre, Montreal, QC, Canada., Musunuru A; Department of Surgery, New York University Grossman School of Medicine and New York University Langone Health, New York, NY., Pol RA; Division of Transplant Surgery, Department of Surgery, University Medical Center Groningen, Groningen, the Netherlands., Hladek MD; Johns Hopkins School of Nursing, Baltimore, MD., Crews DC; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD., Segev DL; Department of Surgery, New York University Grossman School of Medicine and New York University Langone Health, New York, NY., McAdams-DeMarco M; Department of Surgery, New York University Grossman School of Medicine and New York University Langone Health, New York, NY.
المصدر: Transplantation [Transplantation] 2024 Apr 01; Vol. 108 (4), pp. 845-853. Date of Electronic Publication: 2023 Aug 01.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0132144 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-6080 (Electronic) Linking ISSN: 00411337 NLM ISO Abbreviation: Transplantation Subsets: MEDLINE
أسماء مطبوعة: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore, Williams & Wilkins.
مواضيع طبية MeSH: Kidney Transplantation*/adverse effects , Kidney Failure, Chronic*/diagnosis , Kidney Failure, Chronic*/surgery, Humans ; Aged ; Renal Dialysis
مستخلص: Background: Evidence suggests that older patients are less frequently placed on the waiting list for kidney transplantation (KT) than their younger counterparts. The trends and magnitude of this age disparity in access to first KT and repeat KT (re-KT) remain unclear.
Methods: Using the US Renal Data System, we identified 2 496 743 adult transplant-naive dialysis patients and 110 338 adult recipients with graft failure between 1995 and 2018. We characterized the secular trends of age disparities and used Cox proportional hazard models to compare the chances of listing and receiving first KT versus re-KT by age (18-64 y versus ≥65 y).
Results: Older transplant-naive dialysis patients were less likely to be listed (adjusted hazard ratio [aHR] = 0.18; 95% confidence interval [CI], 0.17-0.18) and receive first KT (aHR = 0.88; 95% CI, 0.87-0.89) compared with their younger counterparts. Additionally, older patients with graft failure had a lower chance of being listed (aHR = 0.40; 95% CI, 0.38-0.41) and receiving re-KT (aHR = 0.76; 95% CI, 0.72-0.81). The magnitude of the age disparity in being listed for first KT was greater than that for re-KT ( Pinteraction  < 0.001), and there were no differences in the age disparities in receiving first KT or re-KT ( Pinteraction  = 0.13). Between 1995 and 2018, the age disparity in listing for first KT reduced significantly ( P  < 0.001), but the age disparities in re-KT remained the same ( P  = 0.16).
Conclusions: Age disparities exist in access to both first KT and re-KT; however, some of this disparity is attenuated among older adults with graft failure. As the proportion of older patients with graft failure rises, a better understanding of factors that preclude their candidacy and identification of appropriate older patients are needed.
Competing Interests: D.L.S. received speaking honoraria from Sanofi and Novartis. S.S. has received an education grant from Amgen Canada. The other authors declare no conflicts of interest.
(Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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معلومات مُعتمدة: R01 DK120518 United States DK NIDDK NIH HHS; K02 AG076883 United States AG NIA NIH HHS; P30 AG021334 United States AG NIA NIH HHS; R01 AG055781 United States AG NIA NIH HHS; K24 AI144954 United States AI NIAID NIH HHS; R01 DK114074 United States DK NIDDK NIH HHS
تواريخ الأحداث: Date Created: 20230801 Date Completed: 20240326 Latest Revision: 20240327
رمز التحديث: 20240327
مُعرف محوري في PubMed: PMC10830888
DOI: 10.1097/TP.0000000000004747
PMID: 37525348
قاعدة البيانات: MEDLINE
الوصف
تدمد:1534-6080
DOI:10.1097/TP.0000000000004747