Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant care
Abstract Background Access to kidney transplantation is limited to more than half of the Mexican population. A fragmented health system, gender, and sociocultural factors are barriers to transplant care. We analyzed kidney transplantation in Mexico and describe how public policies and sociocultural...
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| Format: | Article |
| Language: | English |
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BMC
2021-03-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-021-02294-1 |
| _version_ | 1818721591424450560 |
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| author | Guillermo Garcia-Garcia Marcello Tonelli Margarita Ibarra-Hernandez Jonathan S. Chavez-Iñiguez Ma. Concepcion Oseguera-Vizcaino |
| author_facet | Guillermo Garcia-Garcia Marcello Tonelli Margarita Ibarra-Hernandez Jonathan S. Chavez-Iñiguez Ma. Concepcion Oseguera-Vizcaino |
| author_sort | Guillermo Garcia-Garcia |
| collection | DOAJ |
| description | Abstract Background Access to kidney transplantation is limited to more than half of the Mexican population. A fragmented health system, gender, and sociocultural factors are barriers to transplant care. We analyzed kidney transplantation in Mexico and describe how public policies and sociocultural factors result in these inequities. Methods Kidney transplant data between 2007 to 2019 were obtained from the National Transplant Center database. Transplant rates and time spent on the waiting list, by age, gender, health system, and insurance status, were estimated. Results During the study period 34,931 transplants were performed. Recipients median age was 29 (IQR 22–42) years, 62.4% were males, and 73.9% were insured. 72.7% transplants were from living-donors. Annual transplant rates increased from 18.9 per million population (pmp) to 23.3 pmp. However, the transplant rate among the uninsured population remained low, at 9.3 transplants pmp. In 2019, 15,890 patients were in the waiting list; 60.6% were males and 88% were insured. Waiting time to transplant was 1.55 (IQR 0.56–3.14) years and it was shorter for patients listed in the Ministry of Health and private facilities, where wait lists are smaller, and for males. Deceased-organ donation rates increased modestly from 2.5 pmp to 3.9 pmp. Conclusions In conclusion, access to kidney transplantation in Mexico is unequal and restricted to patients with medical insurance. An inefficient organ procurement program results in low rates of deceased-donor kidneys. The implementation of a comprehensive kidney care program, recognizing kidney transplantation as the therapy of choice for renal failure, offers an opportunity to correct these inequalities. |
| first_indexed | 2024-12-17T20:41:10Z |
| format | Article |
| id | doaj.art-3c099c09b7474ba080bb8b7d26dc0890 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-17T20:41:10Z |
| publishDate | 2021-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-3c099c09b7474ba080bb8b7d26dc08902022-12-21T21:33:19ZengBMCBMC Nephrology1471-23692021-03-0122111210.1186/s12882-021-02294-1Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant careGuillermo Garcia-Garcia0Marcello Tonelli1Margarita Ibarra-Hernandez2Jonathan S. Chavez-Iñiguez3Ma. Concepcion Oseguera-Vizcaino4Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraDepartment of Medicine, University of CalgaryNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraNephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Centro Universitario de Ciencias de la Salud, Universidad de GuadalajaraAbstract Background Access to kidney transplantation is limited to more than half of the Mexican population. A fragmented health system, gender, and sociocultural factors are barriers to transplant care. We analyzed kidney transplantation in Mexico and describe how public policies and sociocultural factors result in these inequities. Methods Kidney transplant data between 2007 to 2019 were obtained from the National Transplant Center database. Transplant rates and time spent on the waiting list, by age, gender, health system, and insurance status, were estimated. Results During the study period 34,931 transplants were performed. Recipients median age was 29 (IQR 22–42) years, 62.4% were males, and 73.9% were insured. 72.7% transplants were from living-donors. Annual transplant rates increased from 18.9 per million population (pmp) to 23.3 pmp. However, the transplant rate among the uninsured population remained low, at 9.3 transplants pmp. In 2019, 15,890 patients were in the waiting list; 60.6% were males and 88% were insured. Waiting time to transplant was 1.55 (IQR 0.56–3.14) years and it was shorter for patients listed in the Ministry of Health and private facilities, where wait lists are smaller, and for males. Deceased-organ donation rates increased modestly from 2.5 pmp to 3.9 pmp. Conclusions In conclusion, access to kidney transplantation in Mexico is unequal and restricted to patients with medical insurance. An inefficient organ procurement program results in low rates of deceased-donor kidneys. The implementation of a comprehensive kidney care program, recognizing kidney transplantation as the therapy of choice for renal failure, offers an opportunity to correct these inequalities.https://doi.org/10.1186/s12882-021-02294-1Kidney transplantationDisparitiesEnd-stage kidney diseaseOrgan donation |
| spellingShingle | Guillermo Garcia-Garcia Marcello Tonelli Margarita Ibarra-Hernandez Jonathan S. Chavez-Iñiguez Ma. Concepcion Oseguera-Vizcaino Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant care BMC Nephrology Kidney transplantation Disparities End-stage kidney disease Organ donation |
| title | Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant care |
| title_full | Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant care |
| title_fullStr | Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant care |
| title_full_unstemmed | Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant care |
| title_short | Access to kidney transplantation in Mexico, 2007–2019: a call to end disparities in transplant care |
| title_sort | access to kidney transplantation in mexico 2007 2019 a call to end disparities in transplant care |
| topic | Kidney transplantation Disparities End-stage kidney disease Organ donation |
| url | https://doi.org/10.1186/s12882-021-02294-1 |
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