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Journal of General Surgery

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Research Article

Interstate Transplant Recipients Exhibit Improved Kidney Allograft Survival Compared to Natives of that State

Meredith Scott, Graham Mitro, Ryan Flynn, Weikai Qu, Michael Rees, Jorge Ortiz

Correspondence Address :

Meredith Scott
Department of Surgery
University of Toledo Medical Center
OH, USA
Tel: (330) 604-5939
Email: Meredith.Scott@rockets.utoledo.edu

Received on: August 11, 2017, Accepted on: September 19, 2017, Published on: September 25, 2017

Citation: Meredith Scott, Graham Mitro, Ryan Flynn, Weikai Qu, Michael Rees, Jorge Ortiz (2017). Interstate Transplant Recipients Exhibit Improved Kidney Allograft Survival Compared to Natives of that State

Copyright: 2017 Meredith Scott, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

  • Abstract

Abstract
Objectives: Regional disparity in access to organs for kidney transplantation has led to inter-state "transplant tourism." Our objective is to examine demographic and outcome differences between "transplant tourists" and regional residents.
Materials and Methods: The Scientific Registry of Transplant Recipients was analyzed to examine deceased donor kidney transplants performed from 03/2006 to 05/2015 at a single institution (n=581). The recipients numbered 329 from Ohio and 252 from Michigan.
Results: The Ohio group exhibited higher incidence of diabetes mellitus (DM; 45.9% vs. 36.7%, p=0.044), lower educational attainment beyond high school (43.2% vs. 72.5%, p<0.001), and greater likelihood of receiving an extended criteria kidney (16.1% vs. 8%, p=0.008). No other demographic differences were noted.
Incidence of delayed graft functions or of rejection at 90 days or 1, 3, or 5 years was equivalent between the two groups. Michigan patients exhibited better death censored graft survival overall (81.6% vs 89%, p=0.022) and at 1-year post transplantation (92.5% vs. 97.3%, p=0.022). The Michigan group also exhibited improved patient survival overall (80.8% vs. 88.6%, p=0.018). Graft loss among Ohioans was associated with elderly (>65 years) status (19.3% vs. 5%, p=0.037), prior renal transplantation (33.3% vs. 17.5%, p=0.045) or high (>20%) panel reactive antibody (PRA; 36.2% vs. 16.3%, p=0.036). Ohio recipients also exhibited decreased patient survival with high panel reactive antibody (23.4% vs. 2.0%, p=0.002), diabetes mellitus, (30.8% vs 16.1%, p=0.021), or with a donation after cardiac death kidney (20.8% vs. 17.4%, p=0.017).
Conclusions: In this single center study, patients traveling from outside the state of transplantation exhibited similar donor and recipient demographics to Ohioans yet experienced superior allograft outcomes and were less affected by risk factors. These
benefits may be tied to socioeconomic factors as evidenced by the discrepancy in education levels.

Keywords: Renal, Transplant, Demographics