Does immigration background influence outcomes after renal transplantation?

Oztek, Fatma Zehra; Tekin, Pinar; Herle, Marion; Mueller, Thomas; Arbeiter, Klaus; Aufricht, Christoph

doi:10.1007/s00467-010-1685-9

Cited by 11 publications

(15 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These findings are similar to those in a study of 59 Austrian children in which patient and graft survival rates did not differ between native Austrian children and immigrants . In that study, undocumented Austrian children were noted to have full access to insurance and government financial support systems.…”

Section: Discussionsupporting

confidence: 87%

Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients

McEnhill

Brennan

Winnicki

et al. 2016

American Journal of Transplantation

View full text Add to dashboard Cite

Kidney transplantation is the optimal treatment for children with end‐stage renal disease. For children with undocumented immigration status, access to kidney transplantation is limited, and data on transplant outcomes in this population are scarce. The goal of the present retrospective single‐center study was to compare outcomes after kidney transplantation in undocumented children with those of US citizen children. Undocumented residency status was identified in 48 (17%) of 289 children who received a kidney transplant between 1998 and 2010. In undocumented recipients, graft survival at 1 and 5 years posttransplantation was similar, and mean estimated glomerular filtration rate at 1 year was higher than that in recipients who were citizens. The risk of allograft failure was lower in undocumented recipients relative to that in citizens at 5 years posttransplantation, after adjustment for patient age, donor age, donor type, and HLA mismatch (p < 0.04). In contrast, nearly one in five undocumented recipients who reached 21 years of age lost their graft, primarily because they were unable to pay for immunosuppressive medications once their state‐funded insurance had ended. These findings support the ongoing need for immigration policies for the undocumented that facilitate access to work‐permits and employment‐related insurance for this disadvantaged group.

show abstract

Section: Discussionsupporting

confidence: 87%

Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients

McEnhill

Brennan

Winnicki

et al. 2016

American Journal of Transplantation

View full text Add to dashboard Cite

show abstract

“…A family's descent was classified as immigrant if the parents of the patient were first-generation immigrants (mother tongue of at least one parent was not German). In Austria, all patients have full insurance that cover all health-related costs, resulting in no disparities in listing and waiting times for KTx (14, 15). Patients who had already undergone transplantation were excluded.…”

Section: Methodsmentioning

confidence: 99%

“…Children from minority groups in the US, particularly African-Americans, wait longer for a deceased donor (DD) KTx, and undergo less living donor (LD) and preemptive KTx compared to children of Caucasians (5–10). In Europe, a large ESPN/ERA-EDTA Registry report recently confirmed racial disparities in access to KTx (11), only few single center studies investigated the role of migration-associated disparities in pediatric KTx despite the increasing role of migration in Europe (12–15). Data from US immigrants are likely not transferable, as European immigrants are less likely to demonstrate racial differences, less likely to represent recent immigrants and mostly exposed to a less restrictive health care system (4, 11, 14, 15).…”

Section: Introductionmentioning

confidence: 99%

High Rate of Living Kidney Donation to Immigrant Children Despite Disparities—An Epidemiological Paradox?

et al. 2019

Self Cite

View full text Add to dashboard Cite

Background: Kidney transplantation is the preferred treatment modality for children with end-stage renal disease. In the adult population, migration-related modifiable factors were associated with low living donation rates; no such data are available on the pediatric population. This pilot study therefore compares donation modality, communication, knowledge, and attitudes/beliefs between families of immigrant and non-immigrant descent. Methods: Demographic and clinical characteristics of a cohort of children from 77 families of immigrant (32; 42%) and non-immigrant (45; 58%) descent who had undergone renal transplantation were assessed and related to donation modality at the Medical University of Vienna. In a representative subset, modifiable migration-related factors were assessed in a questionnaire-based study. Results: In immigrant families, information delay, limited communication, low knowledge levels, and self-reported conflicting beliefs were significantly more prevalent than in non-immigrants. The living kidney donation rate to children was high in both populations (immigrants: 63%, non-immigrants: 44%; p = 0.12). Living donation to children on dialysis was even significantly higher in immigrant families (immigrants: 13 out of 20; 57%, non-immigrants: 9 out of 33; 27%; p = 0.03). Conclusion: Contrary to expectations, migration-related disparities did not translate into decreased living donation rates in immigrant families, in particular to children on dialysis. Certain factors might therefore be less important for the living donation process in pediatric care structures and/or might be overcome by yet undefined protective factors. Larger pediatric studies including qualitative and quantitative methods are required to validate and refine current conceptual frameworks integrating the perspective of affected families.

show abstract

“…European data suggest that immigration may be associated with inferior KT outcomes in some [19,20] but not all situations [21–25]. Studies on the association between immigration background and KT outcomes remain limited in Europe, and only few if any have assessed long‐term kidney graft function decline rate (i.e., change over time in estimated Glomerular Filtration Rate, eGFR) beyond 1‐year post‐transplant.…”

Section: Introductionmentioning

confidence: 99%

“…Studies on the association between immigration background and KT outcomes remain limited in Europe, and only few if any have assessed long‐term kidney graft function decline rate (i.e., change over time in estimated Glomerular Filtration Rate, eGFR) beyond 1‐year post‐transplant. Previous studies have shown that eGFR decline at 1‐year post‐transplant does not differ significantly between KTRs with a non‐European immigration background and natives [20,21,25]. Most registries lack long‐term longitudinal data on eGFR.…”

Section: Introductionmentioning

confidence: 99%

Association of immigration background with kidney graft function in a publicly funded health system: a nationwide retrospective cohort study in Italy

et al. 2020

View full text Add to dashboard Cite

The impact of immigration background on kidney graft function (eGFR) is unknown. Italy has a publicly funded health system with universal coverage. Since immigration from non-European Union (EU) countries beyond Eastern Europe is a recent and extensive phenomenon, Italy is a rather unique setting for studying the effect of immigration status as a socioeconomic and cultural condition. We retrospectively identified all adult deceased donor kidney transplant recipients (KTRs) in Italy (2010-2015) and followed them until death, dialysis or 5-years post-transplantation; 6346 were EU-born, 161 Eastern European-born, and 490 non-Europeanborn. We examined changes in eGFR after 1-year post-transplant using multivariable-adjusted joint longitudinal survival random-intercept Cox regression. Compared to EU-born KTRs, in non-European-born KTRs the adjusted average yearly eGFR decline was À0.96 ml/min/year (95% confidence interval: À1.48 to À0.45; P < 0.001), whereas it was similar in Eastern European-born KTRs [+0.02 ml/min/year (À0.77 to +0.81; P = 0.96)]. Adjusted 5-year transplant survival did not statistically differ between non-European-born, Eastern European-born, and EU-born. In those surviving beyond 1-year, it was 91.8% in EU-born (87.1-96.8), 92.5% in Eastern European-born (86.1-99.4), and 89.3% in non-European-born KTRs (83.0-96.0). This study provides evidence that among EU KTRs, non-European immigration background is associated with eGFR decline.

show abstract

Does immigration background influence outcomes after renal transplantation?

Cited by 11 publications

References 22 publications

Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients

Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients

High Rate of Living Kidney Donation to Immigrant Children Despite Disparities—An Epidemiological Paradox?

Association of immigration background with kidney graft function in a publicly funded health system: a nationwide retrospective cohort study in Italy

Contact Info

Product

Resources

About