Introduction: This paper analyzes the results of the impact of the Kidney Transplant Program in a Public Hospital in the province of Misiones, Argentina.  The population are patients who have been indicated a kidney transplant without medical insurance coverage.

Objectives: To analyze the impact of this program on the accessibility of the waiting list for kidney transplant and for the kidney transplant itself in the region. Demonstrate the social equity achieved in access to kidney transplant (KT) and in the admission to the waiting list (WL).

Methodology: We used CRESI (incucai statistical system) to collect and analyze data before and after the creation of the renal transplant team.

Results: In Argentina the population with Terminal Kidney Disease (TKD) is of 28821 patients, the WL for KT is of 5088 patients. Misiones has a population of 1284760 inhabitants, 667 of whom have TKD. The population with TKD has a growth rate that shows a sustained increase of 4.09% annual average since 2013. Diabetic nephropathy is the main cause. The Madariaga Hospital Transplant Service (Posadas, Misiones) has been created in 2018 with the purpose of ensuring the opportunity for KT in an equitable manner for the population of the province and guaranteeing equity to all patients in the province who need to enter WL and receive a transplant in a timely manner. Thanks to the development of this new transplant center, it has been possible to increase significantly the transplant rate in the province of Misiones. With the creation of the public transplant program. Three variables have multiplied exponentially: 1- The number of patients on the WL 2- The number of transplants 3- The rate of organ and tissue donation in the hospitals of the province. The population with TKD without health insurance in the province increases annually, as does the number of patients in hemodialysis (HD). Until 2018 there was a strong rising curve. However, since 2018 there has been a trend towards a flattening of this curve.

Discussion: The political decision to form this team in a highly complex hospital is to guarantee health care to the entire population of the province regardless of their health insurance. The equity of this program is due to the response provided to the entire province in a homogeneous way. Supported by the hospital dialysis centers all around the province, coordinating studies for admission to WL, and coordinating the patient transfers from all over the province. Despite the rising incidence of the KTD population, having been able to increase the WL and the 74 transplants performed so far have achieved a flattening in the historical upward curve of HD patients year after year. We therefore believe that this data demonstrates effectiveness in the process. Observing that the trend begins to change and seeing the projection of it over time speaks of a more encouraging future for the entire population, prioritizing the most in need patients.