Kidney transplantation and withdrawal rates among wait-listed first-generation immigrants in Italy.
Background Multiple barriers diminish access to kidney transplantation (KT) in immigrant compared to non-immigrant populations. It is unknown whether immigration status reduces the likelihood of KT after wait-listing despite universal healthcare coverage with uniform access to transplantation. Metho...
| Publicado en: | European Journal of Public Health Vol. 32; no. 3; pp. 372 - 379 |
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| Autores principales: | , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157279782&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157279782 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11011262 BHW jtl: European Journal of Public Health issn: 11011262 maglogo: N pubinfo: dt: Jun2022 vid: 32 iid: 3 pid: 622 pub: Oxford University Press / USA artinfo: ui: 157279782 157279782 157279782 10.1093/eurpub/ckac027 157279782 ppf: 372 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Kidney transplantation and withdrawal rates among wait-listed first-generation immigrants in Italy. aug: au: Grossi, Alessandra Agnese Puoti, Francesca Fiaschetti, Pamela Ciaccio, Paola Di Maggiore, Umberto Cardillo, Massimo affil: Department of Human Sciences, Innovation and Territory, University of Insubria , Como, Italy sug: subj: Kidney Transplantation Immigrants Italy Treatment Withdrawal Human Italy Retrospective Design Adult Multiple Regression Probability European Union Confidence Intervals Living Donors Adult: 19-44 years ab: Background Multiple barriers diminish access to kidney transplantation (KT) in immigrant compared to non-immigrant populations. It is unknown whether immigration status reduces the likelihood of KT after wait-listing despite universal healthcare coverage with uniform access to transplantation. Methods We retrospectively collected data of all adult waiting list (WL) registrants in Italy (2010–20) followed for 5 years until death, KT in a foreign center, deceased-donor kidney transplant (DDKT), living-donor kidney transplant (LDKT) or permanent withdrawal from the WL. We calculated adjusted relative probability of DDKT, LDKT and permanent WL withdrawal in different immigrant categories using competing-risks multiple regression models. Results Patients were European Union (EU)-born (n = 21 624), Eastern European-born (n = 606) and non-European-born (n = 1944). After controlling for age, sex, blood type, dialysis vintage, case-mix and sensitization status, non-European-born patients had lower LDKT rates compared to other immigrant categories: LDKT adjusted relative probability of non-European-born vs. Eastern European-born 0.51 (95% CI: 0.33–0.79; P = 0.002); of non-European-born vs. EU-Born: 0.65 (95% CI: 0.47–0.82; P = 0.001). Immigration status did not affect the rate of DDKT or permanent WL withdrawal. Conclusions Among EU WL registrants, non-European immigration background is associated with reduced likelihood of LDKT but similar likelihood of DDKT and permanent WL withdrawal. Wherever not available, new national policies should enable coverage of travel and medical fees for living-donor surgery and follow-up for non-resident donors to improve uptake of LDKT in immigrant patients, and provide KT education that is culturally competent, individually tailored and easily understandable for patients and their potential living donors. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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