Training, education & increasing donation

Tuesday September 13, 2022 from 17:35 to 18:35

Room: CF-2

341.10 Disparity in access to Kidney Transplantation in the Province of Buenos Aires, Argentina

Abstract

Disparity in access to kidney transplantation in the province of Buenos Aires, Argentina

Hugo Petrone1, Dante D Garcia1, Graciela G Klein1, Francisco F Leone1.

1Networks of Public Transplant Service, CUCAIBA, La Plata, Argentina

Introduction: Kidney Transplantation (KT) is a practice characterized by a high demand for the supply of available kidney grafts. There are certain conditions that affect the accessibility of groups of patients to this treatment. The objective was to evaluate factors of disparity, traditionally recognized, in access to KT in the province of Buenos Aires, Argentina, taking the year 2019 as the analysis period to avoid the effects of the Covid 19 pandemic on it.

Methods: The following variables on accessibility to KT were analyzed: funder, sex, age and cause of Chronic Renal Insufficiency. For the analysis of transplant activity, the indicator Transplants per 100 patients exposed to risk per year was used. For the analysis, the Argentine Registry of Chronic Dialysis 2019 and the National Procurement and Transplant System of the Argentine Republic (SINTRA) were used as data sources.

Results: The mean time (in months) to enter the Waiting List (WL) of patients with Public Subsidy was 14 months compared to 11 months as the mean time of all patients in the Province of Buenos Aires. The average stay in WL from admission to the transplant was 57 months in subsidized patients, while the provincial average was 40 months. Of the total number of RTs performed in 2019 on Buenos Aires patients (n= 494), 101 were performed on patients with public subsidies (20%), when it is estimated that 40% of people have public coverage in the province of Buenos Aires. 59% of the transplants (n=292) were performed on men, with women being more frequent donors for their husbands, fathers, brothers and sons. When diabetes was analyzed as a cause of End-Stage Chronic Kidney Disease, it was observed that in patients over 44 years of age, the rate of transplants per 100 patients per year exposed to risk was 2.6 vs. 5.5 in the other causes. Regarding age, an increase in transplant rates (100 patients exposed to risk per year) was observed in all age groups (including those over 65 years of age) in the last 10 years, being in the year 2019: 0 -19 years: 26.9, 20-44 years: 8.6, 45-64 years: 4.9 and over 65 years: 1.9.

Conclusion: In the Renal Transplant activity in the province of Buenos Aires, a disparity in access was observed for the population with public subsidies compared to the group that has social security coverage.Women were transplanted less than men despite being more active as donors in Renal Transplantation with living donor. Patients with diabetes over 44 years of age have lower transplant rates than kidney patients with other causes, and in all age groups there was an increase in transplant rates, although it decreases as the age increases.



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