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...

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Publicado en:European Journal of Public Health Vol. 32; no. 3; pp. 372 - 379
Autores principales: Grossi, Alessandra Agnese, Puoti, Francesca, Fiaschetti, Pamela, Ciaccio, Paola Di, Maggiore, Umberto, Cardillo, Massimo
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA Jun2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2022
      vid: 32
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      pub: Oxford University Press / USA
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        10.1093/eurpub/ckac027
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        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
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