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Demographic, psychosocial and health disparities between living and deceased renal allograft recipients in Switzerland

Rita Achermann, Michael Koller, Sabina De Geest, Karine Hadaya, Thomas F Müller, Uyen Huynh-Do, Manuel Pascual, Jürg Steiger, Alexander Kiss, Isabelle Binet & The Psychosocial Interest Group And The Swiss Transplant Cohort Study

abstract

BACKGROUND
Living donor renal transplantation is widely performed in Switzerland with a superior long-term outcome and lower waiting time compared with deceased renal transplantation. However the chances of receiving a living donor kidney transplant are not the same for all transplant candidates. The current study aimed to identify psychosocial and demographic characteristics that predict lower access to living kidney donation in Switzerland.

METHODS
The study was a nationwide multicentre study nested within the Swiss Transplant Cohort Study. Pre-transplant demographic, psychosocial and health characteristics of 1126 deceased and 859 living renal transplant recipients were compared using logistic regression analysis.

RESULTS
Transplant candidates with higher age (odds ratio [OR] per 10 years 0.67, 95% confidence interval [CI] 0.60–0.74), lower education (OR 0.46, 95% CI 0.36–0.59), a work capacity of less than 50% (OR 0.48, 95% CI 0.35–0.66), single or formerly married (OR 0.38, 95% CI 0.26–0.53 / OR 0.37, 95% CI 0.26–0.53) or with a higher hospital depression score (OR per 5 points 0.61, 95% CI 0.50–0.74) were less likely to receive an allograft from a living donor. In some regions of Switzerland candidates were more likely to undergo living transplantation than in other regions. No association was found with gender or income.

CONCLUSIONS
Interventions to increase access to kidney transplantation from living donors should target transplant candidates of older age, lower education, lower working capacity and not living in a committed relationship. The observed regional differences suggest that additional determinants of living donation may play a role such as population and health professional attitudes toward living donation.
   
citation Achermann R, Koller M, De Geest S, Hadaya K, Müller T F, Huynh-Do U, Pascual M, Steiger J, Kiss A, Binet I, The Psychosocial Interest Group And The Swiss Transplant Cohort Study . Demographic, psychosocial and health disparities between living and deceased renal allograft recipients in Switzerland. Swiss Med Wkly 2021; 151:w20532.
   
type journal paper/review (English)
date of publishing 12-08-2021
journal title Swiss Med Wkly (151)
ISSN electronic 1424-3997
pages w20532
PubMed 34382664
DOI 10.4414/smw.2021.20532