Guillermo Garcia-Garcia1, Marcello Tonelli2, Margarita Ibarra-Hernandez3, Jonathan S Chavez-Iñiguez3, Ma Concepcion Oseguera-Vizcaino3. 1. Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital 278, Jal., CP 44280, Guadalajara, Mexico. ggarcia1952@gmail.com. 2. Department of Medicine, University of Calgary, A100, Administration Building, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada. 3. Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Hospital 278, Jal., CP 44280, Guadalajara, Mexico.
Abstract
BACKGROUND: Access to kidney transplantation is limited to more than half of the Mexican population. A fragmented health system, gender, and sociocultural factors are barriers to transplant care. We analyzed kidney transplantation in Mexico and describe how public policies and sociocultural factors result in these inequities. METHODS: Kidney transplant data between 2007 to 2019 were obtained from the National Transplant Center database. Transplant rates and time spent on the waiting list, by age, gender, health system, and insurance status, were estimated. RESULTS: During the study period 34,931 transplants were performed. Recipients median age was 29 (IQR 22-42) years, 62.4% were males, and 73.9% were insured. 72.7% transplants were from living-donors. Annual transplant rates increased from 18.9 per million population (pmp) to 23.3 pmp. However, the transplant rate among the uninsured population remained low, at 9.3 transplants pmp. In 2019, 15,890 patients were in the waiting list; 60.6% were males and 88% were insured. Waiting time to transplant was 1.55 (IQR 0.56-3.14) years and it was shorter for patients listed in the Ministry of Health and private facilities, where wait lists are smaller, and for males. Deceased-organ donation rates increased modestly from 2.5 pmp to 3.9 pmp. CONCLUSIONS: In conclusion, access to kidney transplantation in Mexico is unequal and restricted to patients with medical insurance. An inefficient organ procurement program results in low rates of deceased-donor kidneys. The implementation of a comprehensive kidney care program, recognizing kidney transplantation as the therapy of choice for renal failure, offers an opportunity to correct these inequalities.
BACKGROUND: Access to kidney transplantation is limited to more than half of the Mexican population. A fragmented health system, gender, and sociocultural factors are barriers to transplant care. We analyzed kidney transplantation in Mexico and describe how public policies and sociocultural factors result in these inequities. METHODS: Kidney transplant data between 2007 to 2019 were obtained from the National Transplant Center database. Transplant rates and time spent on the waiting list, by age, gender, health system, and insurance status, were estimated. RESULTS: During the study period 34,931 transplants were performed. Recipients median age was 29 (IQR 22-42) years, 62.4% were males, and 73.9% were insured. 72.7% transplants were from living-donors. Annual transplant rates increased from 18.9 per million population (pmp) to 23.3 pmp. However, the transplant rate among the uninsured population remained low, at 9.3 transplants pmp. In 2019, 15,890 patients were in the waiting list; 60.6% were males and 88% were insured. Waiting time to transplant was 1.55 (IQR 0.56-3.14) years and it was shorter for patients listed in the Ministry of Health and private facilities, where wait lists are smaller, and for males. Deceased-organ donation rates increased modestly from 2.5 pmp to 3.9 pmp. CONCLUSIONS: In conclusion, access to kidney transplantation in Mexico is unequal and restricted to patients with medical insurance. An inefficient organ procurement program results in low rates of deceased-donor kidneys. The implementation of a comprehensive kidney care program, recognizing kidney transplantation as the therapy of choice for renal failure, offers an opportunity to correct these inequalities.
Entities:
Keywords:
Disparities; End-stage kidney disease; Kidney transplantation; Organ donation
Authors: Julio Frenk; Eduardo González-Pier; Octavio Gómez-Dantés; Miguel A Lezana; Felicia Marie Knaul Journal: Lancet Date: 2006-10-28 Impact factor: 79.321
Authors: Francisco Javier Mercado-Martínez; Eduardo Hernández-Ibarra; Carlos D Ascencio-Mera; Blanca A Díaz-Medina; Cesar Padilla-Altamira; Ciara Kierans Journal: Cad Saude Publica Date: 2014-10 Impact factor: 1.632