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Author Notes:

Corresponding Author: Jennifer Gander; Emory University School of Medicine, Division of Transplantation Atlanta, GA; Telephone: (404)-727-9994; Fax: (404)-727-3660; Email: jennifer.grander@emory.edu

The authors acknowledge the Southeastern Kidney Council and all of the members of the Southeastern Kidney Transplant Coalition for their significant assistance with this work.

The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIDDK, NIMHD or the NIH.

The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Dr. Pastan is a minority shareholder in Fresenius College Park Dialysis, College Park, GA.


Research Funding:

The authors disclosed receipt of the following financial support for the research, authorship, and or publication of this article: This work was supported in part by NIH NIDDK Award R15DK088707 (Browne) and NIH NIMHD Award R24MD008077 (Amamoo, Gander, Patzer, Pastan).


  • Science & Technology
  • Life Sciences & Biomedicine
  • Urology & Nephrology
  • Dialysis
  • Chronic kidney failure
  • Kidney transplantation
  • Patient education

Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast


Journal Title:

American Journal of Nephrology


Volume 41, Number 6


, Pages 504-511

Type of Work:

Article | Post-print: After Peer Review


Background: Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. Methods: A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Results: Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Conclusions: Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.

Copyright information:

© 2015 S. Karger AG, Basel

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