ArticleJournal of the American Society of Nephrology : JASN2021
Association between Longer Travel Distance for Transplant Care and Access to Kidney Transplantation and Graft Survival in the United States.
Article in Journal of the American Society of Nephrology : JASN, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed.
- Social Risk Factors and Kidney Transplant Waitlisting Among Patients Receiving Dialysis: A National Cohort Study.Kidney medicine · 2026Article
- Social determinants of health and pediatric kidney transplant outcomes.Pediatric nephrology (Berlin, Germany) · 2025Article
- A geospatial analysis of liver transplant centers and alcohol-related liver disease across the United States.Journal of liver transplantation · 2025Article
- Pediatric Nephrology Workforce and Access of Children with Kidney Failure to Transplantation in the United States.Journal of the American Society of Nephrology : JASN · 2025Article
- Neighborhood Disadvantage and Inequities in Access to Preemptive and Living Kidney Transplantation.Kidney360 · 2025Article
- Association of a Liver Allocation Policy Change With Domestic Travel for Liver Transplantation.Transplantation direct · 2025Article
- Technology-Enabled Remote Patient Monitoring and Education to Improve Kidney Transplant Knowledge, Access, and Post-Transplant Care: A Narrative Review.Current transplantation reports · 2025Article
- Disparities in Liver Transplant Outcomes: Race/Ethnicity and Individual- and Neighborhood-Level Socioeconomic Status.Clinical nursing research · 2024Article
- Collaboration between local nephrologists and the transplant centre ensures good outcomes in post-transplant care.Clinical kidney journal · 2023Article
- Listing at non-local transplant centers is associated with increased access to deceased donor kidney transplantation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2022Article
- A scoping review of inequities in access to organ transplant in the United States.International journal for equity in health · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundTransplant candidates may gain an advantage by traveling to receive care at a transplant center that may have more favorable characteristics than their local center. Factors associated with longer travel distance for transplant care and whether the excess travel distance (ETD) is associated with access to transplantation or with graft failure are unknown.
methodsThis study of adults in the United States wait-listed for kidney transplantation in 1995-2015 used ETD, defined as distance a patient traveled beyond the nearest transplant center for initial waiting list registration. We used linear regression to examine patient and center characteristics associated with ETD and Fine-Gray models to examine the association between ETD (modeled as a spline) and time to deceased or living donor transplantation or graft failure.
resultsOf 373,365 patients, 11% had an ETD≥50 miles. Traveling excess distance was more likely among patients who were of non-Black race or those whose nearest transplant center had lower annual living donor transplant volume. At an ETD of 50 miles, we observed a lower likelihood of deceased donor transplantation (subhazard ratio [SHR], 0.85; 95% confidence interval [95% CI], 0.84 to 0.87) but higher likelihood of living donor transplantation (SHR, 1.14; 95% CI, 1.12 to 1.16) compared with those who received care at their nearest center. ETD was weakly associated with higher risk of graft failure.
conclusionsPatients who travel excess distances for transplant care have better access to living donor but not deceased donor transplantation and slightly higher risk of graft failure. Traveling excess distances is not clearly associated with better outcomes, especially if living donors are unavailable.
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