The Number of Discarded Kidneys Is Likely Much Larger Than Reported

Abstract

In multivariable modeling, factors associated with a decreased likelihood of having primary care included calendar year (adjusted odds ratio [aOR], 0.97 for each year from 2002 through 2015 [95% CI, 0.97-0.98]), male sex (aOR vs female sex, 0.59 [95% CI, 0.57-0.60]), Latino race/ethnicity (aOR vs white, 0.80 [95% CI, 0.77-0.84]), black race/ ethnicity (aOR vs white, 0.88 [95% CI, 0.84-0.93]), Asian race/ethnicity (aOR vs white, 0.67 [95% CI, 0.62-0.74]), not having insurance (aOR vs private insurance, 0.29 [95% CI, 0.27-0.30]), and Southern US Census Bureau region (aOR vs Northeast, 0.53 [95% CI, 0.48-0.58]) (Table ).Discussion | From 2002 through 2015, a decreasing proportion of Americans had an identified source of primary care, especially Americans who were younger, less medically complex, of minority background, or living in the South. To improve Americans' health in an efficient and cost-effective manner, policy makers should prioritize increasing the proportion of Americans with primary care.The decrease in receipt of primary care, particularly among younger patients or patients with no chronic medical conditions, may be related to their choosing nonlongitudinal interactions over continuity, perhaps related to the convenience revolution 3 and a perception that primary care has failed to adopt new modes of delivering treatment that might be more accessible to patients. 4,5 Financial barriers, especially among uninsured Americans, may prevent some people from accessing primary care. Shortages in the availability of primary care may pose access barriers even to insured people, with the result that fewer younger and healthier patients have a regular source of care. 6

Simply Adding Oxygen during Hypothermic Machine Perfusion to Combat the Negative Effects of Ischemia-Reperfusion Injury: Fundamentals and Current Evidence for Kidneys

“…In the United states, more than 15% of machine-perfused kidneys are discarded annually, partially based on elevated renal resistance [78][79][80][81]. However, the only prospective study to determine the true value of the renal resistance during HMP is the Eurotransplant machine perfusion trial [82].…”