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Rural patients
less likely to receive organ transplants
Newswise — Patients in
small towns and isolated rural areas have
lower organ transplant rates and are less
likely to be wait-listed than patients in
urban areas, according to a study in the
January 9/16 issue of JAMA.
Organ transplantation
offers the best, and often only hope for
long-term survival for patients with
end-stage heart, liver, and kidney disease.
However, despite
federal regulation and national efforts to
ensure equal access to the limited pool of
donated organs, previous research has
demonstrated the presence of significant
barriers to access to transplantation
services for racial minorities, women, and
patients with low socioeconomic status or
poor insurance, according to background
information in the article.
Rural residents
represent another group that may have
impaired access to transplant services.
Nearly 14 percent of the U.S. population
lives outside major urban areas.
David A. Axelrod, M.D.,
M.B.A., of Dartmouth Medical School,
Lebanon, N.H., and colleagues assessed the
impact of rural residence on waiting list
registration for heart, liver, and kidney
transplant and rates of transplantation
among wait-listed candidates.
A total of 174,630
patients who were wait-listed and who
underwent heart, liver, or kidney
transplantation between 1999 and 2004 were
included in the study.
The researchers found
significant disparities in access to organ
transplantation between rural and urban
populations.
“This study
demonstrates that patients living in small
towns and isolated rural regions were eight
percent to 15 percent less likely to be
wait-listed and ten percent to 20 percent
less likely to undergo heart, liver, and
kidney transplantation than patients in
urban environments,” the authors write.
They suggest these
discrepancies may be related to differences
in the burden of disease in rural
environments or reduced access to entering
the waiting list.
And they warn that the
increasing concentration of transplant
services in high-volume urban centers may
lead to increased access barriers for rural
patients.
“Further assessment of
the disease burden facing rural residents
and the barriers in access
