BACKGROUND: Allocation of organs is organized on a regional basis in France. We assessed regional differences in access to organ transplant. MATERIAL AND METHODS: We used the recipient database and the waiting list database from the year 1994 onward. We estimated median waiting time by region and organ. The probability of receiving a transplant was estimated using the Kaplan-Meier method. Between-region comparisons used the log-rank test, with adjustment for blood type and disease category. RESULTS: At the end of a 4-month follow-up period, 49% of 3,553 patients had received transplants: 64% of 797 benefited from liver transplants, 52% of 549 from heart transplants, and 22% of 2,207 from kidney transplants. Death rates on the waiting lists were 10%, 14%, and 1% for patients selected for liver, heart, and kidney transplant, respectively. Transplantation percentage (all organs) decreased from 63% in the West to 43% in the Paris region and mortality increased from 2% in the West to 7% in the Southeast. All tests of inter-regional differences were statistically significant. CONCLUSION: Factors explaining geographic differences related to the background of transplant teams, activity of organ procurement, and severity of patients on the list.
BACKGROUND: Allocation of organs is organized on a regional basis in France. We assessed regional differences in access to organ transplant. MATERIAL AND METHODS: We used the recipient database and the waiting list database from the year 1994 onward. We estimated median waiting time by region and organ. The probability of receiving a transplant was estimated using the Kaplan-Meier method. Between-region comparisons used the log-rank test, with adjustment for blood type and disease category. RESULTS: At the end of a 4-month follow-up period, 49% of 3,553 patients had received transplants: 64% of 797 benefited from liver transplants, 52% of 549 from heart transplants, and 22% of 2,207 from kidney transplants. Death rates on the waiting lists were 10%, 14%, and 1% for patients selected for liver, heart, and kidney transplant, respectively. Transplantation percentage (all organs) decreased from 63% in the West to 43% in the Paris region and mortality increased from 2% in the West to 7% in the Southeast. All tests of inter-regional differences were statistically significant. CONCLUSION: Factors explaining geographic differences related to the background of transplant teams, activity of organ procurement, and severity of patients on the list.
Authors: Marcello Tonelli; Scott Klarenbach; Braden Manns; Bruce Culleton; Brenda Hemmelgarn; Stefania Bertazzon; Natasha Wiebe; John S Gill Journal: CMAJ Date: 2006-08-29 Impact factor: 8.262