Access to renal transplantation
Download
1 / 18

Access to renal transplantation - PowerPoint PPT Presentation


  • 158 Views
  • Updated On :

Access to renal transplantation. Chris Dudley UKRR/UKT Joint analysis. Equity in renal transplantion. Equitable organ allocation (UKT) Equitable access to the waiting list (unit level). Deceased donor kidney programme. Problems. Point prevalence analysis Short-term fluctuation

Related searches for Access to renal transplantation

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Access to renal transplantation' - overton


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Access to renal transplantation l.jpg

Access to renal transplantation

Chris Dudley

UKRR/UKT Joint analysis


Equity in renal transplantion l.jpg
Equity in renal transplantion

  • Equitable organ allocation (UKT)

  • Equitable access to the waiting list (unit level)


Slide4 l.jpg

Deceased donor kidney programme


Problems l.jpg
Problems

  • Point prevalence analysis

    • Short-term fluctuation

    • Enrichment with unsuitable patients


Renal association clinical practice guidelines transplant module l.jpg
Renal Association Clinical Practice Guidelines – Transplant module

Guideline 1.4

There must be demonstrable equity of access to deceased donor kidney transplantation irrespective of gender, ethnicity or district of residence.


Renal association clinical practice guidelines transplant module7 l.jpg
Renal Association Clinical Practice Guidelines – Transplant module

Audit measures

  • The time to placement on the UK Transplant national transplant list in relation to start date of dialysis

  • A comparison between renal units of the proportion of dialysis patients placed on the national transplant list corrected for differences in identified unit and patient specific variables including co-morbidity.


Analysis l.jpg
Analysis Transplant module

  • Access to the waiting list

    • Prevalent patients

    • Incident patients

  • Time to listing


Access to the waiting list l.jpg
Access to the waiting list Transplant module

  • Point prevalence analysis

    The proportion of patients on dialysis who were also active on the waiting list on 31/12/06

  • Incident patient analysis

    The % of incident dialysis patients between 01/01/03 – 31/12/04 were subsequently activated on the WL within 2 years of commencing dialysis

  • Only patients <65 years were considered for inclusion


Slide10 l.jpg

Percentage of all dialysis patients by centre on the active transplant waiting list on 31/12/2006 for patients aged under 65


Point prevalence n 11 554 l.jpg
Point prevalence transplant waiting list on 31/12/2006 for patients aged under 65 n = 11,554


Slide12 l.jpg

Percentage of incident patients aged <65 years active on the transplant waiting list within 2 years of commencement of dialysis


Incident patient n 4816 l.jpg
Incident patient transplant waiting list within 2 years of commencement of dialysisn = 4816


Time to wait listing l.jpg
Time to wait-listing transplant waiting list within 2 years of commencement of dialysis

  • Incident patients between 01/01/03 – 31/12/04 used as cohort for consideration and then followed up until 30/09/07

  • Time taken to activate on WL = date of first activation – date of start of dialysis

  • Patients achieving pre-emptive deceased or live donor transplantation were considered to have spent 0 days on the WL


Time to wait listing n 4804 l.jpg
Time to wait-listing transplant waiting list within 2 years of commencement of dialysisn=4804

Significant centre variation [P < 0.0001] persisted even after correcting for

age, gender and PRD


Combined unit performance incident patients l.jpg
Combined unit performance transplant waiting list within 2 years of commencement of dialysis[Incident patients]

IDEAL

SLOW

LOW

LOW & SLOW


Conclusions l.jpg
Conclusions transplant waiting list within 2 years of commencement of dialysis

  • Several units are significant outliers in % of both prevalent and incident patient wait-listed

  • Several units are significant outliers in the time taken to activate patients on the waiting list

  • Some units have both a low % of incident patients on the waiting list and take longer to work patients up for activation

  • The reason for differences between units needs to be explored


Cautions l.jpg
Cautions transplant waiting list within 2 years of commencement of dialysis

Need to correct for patient and centre specific factors

  • Patient

    • Age

    • PRD

    • Graft number

  • Centre

    • Size of renal unit

    • Size of LD programme

    • Listing practice of LD transplants


ad