ArticleJournal of the American Society of Nephrology : JASN2014
Geographic determinants of access to pediatric deceased donor kidney transplantation.
Article in Journal of the American Society of Nephrology : JASN, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The psychosocial factors influencing paediatric kidney transplantation access, their outcomes and the patient and family's perceived quality of life: a systematic review and meta-analysis.Pediatric nephrology (Berlin, Germany) · 2026Pooled it
- Allocation of Kidney Allografts From Donors With Kidney Donor Profile Index <35% and the Impact of Kidney Donor Profile Index Revisions on Access to Transplantation for Children.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026Article
- Predicting wait time for pediatric kidney transplant: a novel index.Pediatric nephrology (Berlin, Germany) · 2024Article
- Rurality of patient residence and access to transplantation among children with kidney failure in the United States.Pediatric nephrology (Berlin, Germany) · 2024Article
- Transplant access for children: there is more to be done.Pediatric nephrology (Berlin, Germany) · 2023Article
- Effect of Policy on Geographic Inequities in Kidney Transplantation.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2022Article
- Allocating kidneys in optimized heterogeneous circles.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2021Article
- Incidence of Initial Renal Replacement Therapy Over the Course of Kidney Disease in Children.American journal of epidemiology · 2019Observational
- Outcomes Among Children Who Received a Kidney Transplant in the United States From a Hepatitis B Core Antibody-Positive Donor, 1995-2010.Journal of the Pediatric Infectious Diseases Society · 2016Article
- Preemptive kidney transplantation is associated with survival benefits among pediatric patients with end-stage renal disease.Kidney international · 2016Article
- Inequalities in access to pediatric ESRD care: a global health challenge.Pediatric nephrology (Berlin, Germany) · 2016Article
- Inequality in pediatric kidney transplantation in Brazil.Pediatric nephrology (Berlin, Germany) · 2016Article
- Association of Body Mass Index with Patient-Centered Outcomes in Children with ESRD.Journal of the American Society of Nephrology : JASN · 2016Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Children receive priority in the allocation of deceased donor kidneys for transplantation in the United States, but because allocation begins locally, geographic differences in population and organ supply may enable variation in pediatric access to transplantation. We assembled a cohort of 3764 individual listings for pediatric kidney transplantation in 2005-2010. For each donor service area, we assigned a category of short (<180 days), medium (181-270 days), or long (>270 days) median waiting time and calculated the ratio of pediatric-quality kidneys to pediatric candidates and the percentage of these kidneys locally diverted to adults. We used multivariable Cox regression analyses to examine the association between donor service area characteristics and time to deceased donor kidney transplantation. The Kaplan-Meier estimate of median waiting time to transplantation was 284 days (95% confidence interval, 263 to 300 days) and varied from 14 to 1313 days across donor service areas. Overall, 29% of pediatric-quality kidneys were locally diverted to adults. Compared with areas with short waiting times, areas with long waiting times had a lower ratio of pediatric-quality kidneys to candidates (3.1 versus 5.9; P<0.001) and more diversions to adults (31% versus 27%; P<0.001). In multivariable regression, a lower kidney to candidate ratio remained associated with longer waiting time (hazard ratio, 0.56 for areas with <2:1 versus reference areas with ≥5:1 kidneys/candidates; P<0.01). Large geographic variation in waiting time for pediatric deceased donor kidney transplantation exists and is highly associated with local supply and demand factors. Future organ allocation policy should address this geographic inequity.
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