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Kidney Week

Abstract: PO2494

Patient Barriers to Kidney Transplantation on the Mexican American Border

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Cardenas, Armando T., University of the Incarnate Word, San Antonio, Texas, United States
  • Zavala Georffino, Julio Paolo, University of the Incarnate Word, San Antonio, Texas, United States
  • Mcnutt, Grace, University of the Incarnate Word, San Antonio, Texas, United States
Background

Hispanics are the largest minority group in the United states and are more likely to develop end-stage renal disease (ESRD) compared with non-Hispanic whites. However, Hispanics with ESRD are less likely to receive a deceased donor kidney transplant. We reviewed data from clinics on the Mexican American border to evaluate barriers to transplantation.

Methods

We gathered data from three dialysis clinics in Laredo, Texas, a city on the Mexican American border. It has a population of approximately 250,000 inhabitants of which 95.6% are Hispanic. The number of patients that were waitlisted or scheduled for living donor transplantation was evaluated. We also determined the number of patients that were referred but not listed and those that were not referred at all and investigated reasons for non-referral.

Results

A total of 285 patients were included in the analysis. 52 patients (18.2%) were waitlisted or scheduled for living donor transplantation. An additional 91 patients (31.9%) were referred but not yet waitlisted nor scheduled for living donor transplantation. A total of 140 (49.1%) were not referred. Of those not referred, the most common reasons included: advanced age (25%), weight (4.2%), malignancy (2.85%), cardiovascular (4.2%), peripheral vascular disease (3.57%), functional status (5.71%), noncompliance (5.71%), transportation (10.71%), and immigration status (7.14%).

Conclusion

Nearly half of ESRD patients were not referred for transplant evaluation and less than half of those referred were waitlisted or scheduled for living donor transplantation. This is lower than previous studies showing a greater percentage of referred patients as waitlisted (up to 66% in some studies). Major barriers to referral included age, immigration status, and transportation limitations. The latter two barriers are likely more of a factor in a Mexican American border town than in other areas of the United States. Identifying these barriers highlight areas for improvement in access to renal transplantation for Hispanics.