Anna Powell-Chandler1, Usman Khalid2, Szabolcs Horvath2, Mohamed A Ilham2, Argiris Asderakis2, Michael R Stephens2. 1. Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK. Electronic address: annapc@doctors.org.uk. 2. Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, UK.
Abstract
BACKGROUND: Following transplantation, many patients travel long distances for follow-up care. Many studies have examined the influence of distance from transplant centre on access to transplantation, but few have examined post-transplant outcomes. MATERIALS AND METHODS: Distance from transplant centre was calculated for all kidney transplant recipients transplanted over a 5-year period. Outcomes measured were rates of acute rejection, graft and patient survival. RESULTS: Complete follow up data was available for 571 of the 585 kidney transplants performed over the study period. Distance from home to transplant centre ranged from 1.3 to 257.4 km (median 33.7 km). Patients were divided into quartiles according to their distance from the transplant centre. Distance from the transplant centre did not influence rates of acute rejection (p = 0.102). One-year graft survival for 'nearest' and 'farthest' quartiles was 99% and 97% respectively and five-year graft survival was 78% and 89% respectively (log rank p-value of 0.212). There were no differences in patient survival at 1 and 5 years between the 'nearest' and 'farthest' groups. CONCLUSION: Distance from transplant centre does not affect early outcomes following kidney transplantation. The centralized practice which involves a low threshold for rapid assessment and readmission of patients post-transplantation appears to provide good outcomes for kidney transplant recipients.
BACKGROUND: Following transplantation, many patients travel long distances for follow-up care. Many studies have examined the influence of distance from transplant centre on access to transplantation, but few have examined post-transplant outcomes. MATERIALS AND METHODS: Distance from transplant centre was calculated for all kidney transplant recipients transplanted over a 5-year period. Outcomes measured were rates of acute rejection, graft and patient survival. RESULTS: Complete follow up data was available for 571 of the 585 kidney transplants performed over the study period. Distance from home to transplant centre ranged from 1.3 to 257.4 km (median 33.7 km). Patients were divided into quartiles according to their distance from the transplant centre. Distance from the transplant centre did not influence rates of acute rejection (p = 0.102). One-year graft survival for 'nearest' and 'farthest' quartiles was 99% and 97% respectively and five-year graft survival was 78% and 89% respectively (log rank p-value of 0.212). There were no differences in patient survival at 1 and 5 years between the 'nearest' and 'farthest' groups. CONCLUSION: Distance from transplant centre does not affect early outcomes following kidney transplantation. The centralized practice which involves a low threshold for rapid assessment and readmission of patients post-transplantation appears to provide good outcomes for kidney transplant recipients.
Authors: Agnieszka Szymańska; Krzysztof Mucha; Maciej Kosieradzki; Sławomir Nazarewski; Leszek Pączek; Bartosz Foroncewicz Journal: Int J Environ Res Public Health Date: 2022-02-11 Impact factor: 3.390
Authors: Shawna Mann; Kyla L Naylor; Eric McArthur; S Joseph Kim; Greg Knoll; Jeffrey Zaltzman; Darin Treleaven; Alexandra Ouedraogo; Anthony Jevnikar; Amit X Garg Journal: Can J Kidney Health Dis Date: 2020-01-25