Demographic and outcome disparities among New York, New Jersey, and Pennsylvania transplant recipients

Abstract

Aim: Geographic variations in kidney transplant outcomes are well documented but poorly understood. This study aims to determine outcome variations among patients from three different states. Methods: A total of 917 renal transplant records were analyzed. Demographics and outcomes were retrospectively compared between the three states of New York (NY), New Jersey (NJ), and Pennsylvania (PA) from 2001 to 2012. The variables were compared with Chi-square test or Mann–Whitney test. We used Kaplan–Meier methodology to compare survival. Results: Higher waitlist times between NY and NJ recipients resulted in earlier transplantation when relisted in Philadelphia. PA recipients received a higher proportion of high-risk and hepatitis C virus (HCV) antibody-positive donors and were more likely to be HCV positive. PA recipients recorded the lowest rate of delayed graft function. Overall patient and graft survival rates at 1 and 3 years were not statistically different between the three states. However, by the end of the study, PA recipients exhibited the highest patient mortality and the highest retransplantation rates. Conclusion: One-year and 3-year patient and graft survival rates were not significantly different. This may be indicative of closer follow-up of PA recipients or longer wait times among NY and NJ candidates. Nevertheless, long-term outcomes were significantly worse in PA patients. Poor long-term outcome may be a manifestation of a sicker overall cohort. Medium-term transplantation results of those patients living in the favorable organ procurement organization are not negatively affected.