Inequality in pediatric kidney transplantation in Brazil

Inequality in pediatric kidney transplantation in Brazil

Author Koch Nogueira, Paulo Cesar Autor UNIFESP Google Scholar
Camargo de Carvalho, Maria Fernanda Google Scholar
Feltran, Luciana de Santis Autor UNIFESP Google Scholar
Konstantyner, Tulio Autor UNIFESP Google Scholar
Sesso, Ricardo Autor UNIFESP Google Scholar
Abstract Background The aim of this study was to describe the access and factors associated with kidney transplantation for children in different regions of Brazil. Methods We analyzed a cohort of 1211 children enrolled on the transplant list from January 2011 to December of 2013. We fitted regression models to investigate factors associated with: (a) undergoing kidney transplantation from a deceased donor, and (b) being removed from the waiting list. Results The incidence of transplantation was uneven across regions, with the lowest rate at 0.4 per million age-related population (pmarp) in the Midwest and the highest incidence rate of 8.3 cases pmarp in the South. Children from the North and the Midwest regions had a 3-4 times lower probability of undergoing a deceased donor transplant (p < 0.05). Apart from the geographic region, age of recipients and GDP influenced the outcome. The likelihood of undergoing transplantation was very low in the youngest children in the North and Midwest. The number of transplant centers was not associated with either outcome. Conclusions Factors of inequality in transplantation in Brazil are of macroeconomic origin, but there is room to reduce inequalities. Training existing transplant center professionals in the care of children could diminish the discrepancies.
Keywords Kidney transplantation
Epidemiology
Demography
Supply and distribution
Pediatrics
xmlui.dri2xhtml.METS-1.0.item-coverage New York
Language English
Date 2016
Published in Pediatric Nephrology. New York, v. 31, n. 3, p. 501-507, 2016.
ISSN 0931-041X (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 501-507
Origin http://dx.doi.org/10.1007/s00467-015-3226-z
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000371425100019
URI https://repositorio.unifesp.br/handle/11600/57916

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