Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant
Abstract Background Kidney transplant improves patients’ survival and quality of life. Worldwide, concern about the equality of access to the renal transplant wait-list is increasing. In Iran, patients have the choice to be placed on either the living or deceased-donor transplant wait-list. Methods...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2020-06-01
|
| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12939-020-01200-9 |
| _version_ | 1818408108962086912 |
|---|---|
| author | Abbas Basiri Maryam Taheri Alireza Khoshdel Shabnam Golshan Hamed Mohseni-rad Nasrin Borumandnia Nasser Simforoosh Mohsen Nafar Majid Aliasgari Mohammad Hossein Nourbala Gholamreza Pourmand Soudabeh Farhangi Nastaran Khalili |
| author_facet | Abbas Basiri Maryam Taheri Alireza Khoshdel Shabnam Golshan Hamed Mohseni-rad Nasrin Borumandnia Nasser Simforoosh Mohsen Nafar Majid Aliasgari Mohammad Hossein Nourbala Gholamreza Pourmand Soudabeh Farhangi Nastaran Khalili |
| author_sort | Abbas Basiri |
| collection | DOAJ |
| description | Abstract Background Kidney transplant improves patients’ survival and quality of life. Worldwide, concern about the equality of access to the renal transplant wait-list is increasing. In Iran, patients have the choice to be placed on either the living or deceased-donor transplant wait-list. Methods This was a prospective study performed on 416 kidney transplant recipients (n = 217 (52.2%) from living donors and n = 199 (47.8%) from deceased donors). Subjects were recruited from four referral kidney transplant centers across Tehran, Iran, during 2016–2017. The primary outcome was to identify the psycho-socioeconomic factors influencing the selection of type of donor (living versus deceased). Secondary objective was to compare the outcomes associated with each type of transplant. The impact of psycho-socioeconomic variables on selecting type of donor was evaluated by using multiple logistic regression and the effect of surgical and non-surgical variables on the early post-transplant creatinine trend was assessed by univariate repeated measure ANOVA. Results Based on standardized coefficients, the main predictors for selecting living donor were academic educational level (adjusted OR = 3.25, 95% CI: 1.176–9.005, p = 0.023), psychological status based on general health questionnaire (GHQ) (adjusted OR = 2.46, 95% CI: 1.105–5.489, p = 0.028), and lower monthly income (adjusted OR = 2.20, 95% CI: 1.242–3.916, p = 0.007). The waiting time was substantially shorter in patients who received kidneys from living donors (p < 0.001). The early post-transplant creatinine trend was more desirable in recipients of living donors (β = 0.80, 95% CI: 0.16–1.44, p-value = 0.014), patients with an ICU stay of fewer than five days (β = − 0.583, 95% CI: − 0.643- -0.522, p-value = < 0.001), and those with less dialysis duration time (β = 0.016, 95% CI: 0.004–0.028, p-value = 0.012). Post-operative surgical outcomes were not different across the two groups of recipients (p = 0.08), however, medical complications occurred considerably less in the living-donor group (p = 0.04). Conclusion Kidney transplant from living donors was associated with shorter transplant wait-list period and better early outcome, however, inequality of access to living donors was observed. Patients with higher socioeconomic status and higher level of education and those suffering from anxiety and sleep disorders were significantly more likely to select living donors. |
| first_indexed | 2024-12-14T09:38:30Z |
| format | Article |
| id | doaj.art-fe324b1a5da643f5bface00e064a0f03 |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-14T09:38:30Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-fe324b1a5da643f5bface00e064a0f032022-12-21T23:07:52ZengBMCInternational Journal for Equity in Health1475-92762020-06-0119111110.1186/s12939-020-01200-9Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplantAbbas Basiri0Maryam Taheri1Alireza Khoshdel2Shabnam Golshan3Hamed Mohseni-rad4Nasrin Borumandnia5Nasser Simforoosh6Mohsen Nafar7Majid Aliasgari8Mohammad Hossein Nourbala9Gholamreza Pourmand10Soudabeh Farhangi11Nastaran Khalili12Urology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesUrology and Nephrology Research Center (UNRC), Shahid Beheshti University of Medical SciencesModern Epidemiology Research Center, Aja University of Medical SciencesUrology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesDepartment of Urology, Ardabil University of Medical SciencesUrology and Nephrology Research Center (UNRC), Shahid Beheshti University of Medical SciencesUrology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesChronic Kidney Disease Research Center, Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesUrology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesBaqiyatallah University of Medical SciencesUrology Research Center, Ibin Sina Medical Center, Tehran University of Medical SciencesShahid Beheshti University of Medical SciencesUrology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesAbstract Background Kidney transplant improves patients’ survival and quality of life. Worldwide, concern about the equality of access to the renal transplant wait-list is increasing. In Iran, patients have the choice to be placed on either the living or deceased-donor transplant wait-list. Methods This was a prospective study performed on 416 kidney transplant recipients (n = 217 (52.2%) from living donors and n = 199 (47.8%) from deceased donors). Subjects were recruited from four referral kidney transplant centers across Tehran, Iran, during 2016–2017. The primary outcome was to identify the psycho-socioeconomic factors influencing the selection of type of donor (living versus deceased). Secondary objective was to compare the outcomes associated with each type of transplant. The impact of psycho-socioeconomic variables on selecting type of donor was evaluated by using multiple logistic regression and the effect of surgical and non-surgical variables on the early post-transplant creatinine trend was assessed by univariate repeated measure ANOVA. Results Based on standardized coefficients, the main predictors for selecting living donor were academic educational level (adjusted OR = 3.25, 95% CI: 1.176–9.005, p = 0.023), psychological status based on general health questionnaire (GHQ) (adjusted OR = 2.46, 95% CI: 1.105–5.489, p = 0.028), and lower monthly income (adjusted OR = 2.20, 95% CI: 1.242–3.916, p = 0.007). The waiting time was substantially shorter in patients who received kidneys from living donors (p < 0.001). The early post-transplant creatinine trend was more desirable in recipients of living donors (β = 0.80, 95% CI: 0.16–1.44, p-value = 0.014), patients with an ICU stay of fewer than five days (β = − 0.583, 95% CI: − 0.643- -0.522, p-value = < 0.001), and those with less dialysis duration time (β = 0.016, 95% CI: 0.004–0.028, p-value = 0.012). Post-operative surgical outcomes were not different across the two groups of recipients (p = 0.08), however, medical complications occurred considerably less in the living-donor group (p = 0.04). Conclusion Kidney transplant from living donors was associated with shorter transplant wait-list period and better early outcome, however, inequality of access to living donors was observed. Patients with higher socioeconomic status and higher level of education and those suffering from anxiety and sleep disorders were significantly more likely to select living donors.http://link.springer.com/article/10.1186/s12939-020-01200-9Deceased donorLiving donorKidney transplantPsychologic statusSocioeconomic |
| spellingShingle | Abbas Basiri Maryam Taheri Alireza Khoshdel Shabnam Golshan Hamed Mohseni-rad Nasrin Borumandnia Nasser Simforoosh Mohsen Nafar Majid Aliasgari Mohammad Hossein Nourbala Gholamreza Pourmand Soudabeh Farhangi Nastaran Khalili Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant International Journal for Equity in Health Deceased donor Living donor Kidney transplant Psychologic status Socioeconomic |
| title | Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant |
| title_full | Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant |
| title_fullStr | Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant |
| title_full_unstemmed | Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant |
| title_short | Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant |
| title_sort | living or deceased donor kidney transplant the role of psycho socioeconomic factors and outcomes associated with each type of transplant |
| topic | Deceased donor Living donor Kidney transplant Psychologic status Socioeconomic |
| url | http://link.springer.com/article/10.1186/s12939-020-01200-9 |
| work_keys_str_mv | AT abbasbasiri livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT maryamtaheri livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT alirezakhoshdel livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT shabnamgolshan livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT hamedmohsenirad livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT nasrinborumandnia livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT nassersimforoosh livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT mohsennafar livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT majidaliasgari livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT mohammadhosseinnourbala livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT gholamrezapourmand livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT soudabehfarhangi livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant AT nastarankhalili livingordeceaseddonorkidneytransplanttheroleofpsychosocioeconomicfactorsandoutcomesassociatedwitheachtypeoftransplant |