MP37-05 DISPARITIES IN ACCESS TO KIDNEY TRANSPLANTATION: ARE AMERICAN TRANSPLANT CENTERS WILLING TO TRANSPLANT INMATES?

Abstract

You have accessJournal of UrologyRenal Transplantation & Vascular Surgery I (MP37)1 Sep 2021MP37-05 DISPARITIES IN ACCESS TO KIDNEY TRANSPLANTATION: ARE AMERICAN TRANSPLANT CENTERS WILLING TO TRANSPLANT INMATES? Lauren Faber, Madeleine Palmer, Michael Davis, and Tania Lyons Lauren FaberLauren Faber More articles by this author , Madeleine PalmerMadeleine Palmer More articles by this author , Michael DavisMichael Davis More articles by this author , and Tania LyonsTania Lyons More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002046.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The United Network for Organ Sharing (UNOS) is tasked with ensuring fair and equitable access to organs for patients seeking transplant. Despite UNOS’ position statement clearly stating that prisoner status should not preclude transplant evaluation, inmates continue to face significant barriers in this arena. The goal of this survey was to discover how many American transplant centers are willing to evaluate, list, and transplant incarcerated individuals. METHODS: All active, adult kidney transplant centers listed on the UNOS website were eligible for inclusion (194). Centers were called up to 3 times for survey. RESULTS: 122 centers responded. 49 were willing to evaluate incarcerated individuals (34 public, 15 private), 43 willing to list (30 public, 13 private), and 42 willing to transplant (30 public, 12 private). 14 centers said yes, but on a case-by-case basis only. Reported considerations were type of crime, length of sentence, and likelihood of release. Frequently cited reasons for not treating inmates were: inadequate follow-up (28), insurance/funding (16), transportation (12), medication compliance (9), security (8), patient safety (8), and lack of social support (5). 24 centers refused to disclose their policy or did not have one. Two centers claimed incarceration was a contraindication to kidney transplantation. CONCLUSIONS: As prevalence of ESRD increases in the incarcerated population, barriers to transplant for inmates need to be addressed. A lack of understanding of the contraindications to transplant or a lack of knowledge about the prisoner system on behalf of transplant centers may contribute to these barriers. However, there is likely a component of implicit bias and ethical dilemma. We feel as transplant professionals it is our responsibility to assist vulnerable patients in overcoming barriers to transplantation and work to ensure equitable access to organs, regardless of incarceration status. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e646-e647 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Lauren Faber More articles by this author Madeleine Palmer More articles by this author Michael Davis More articles by this author Tania Lyons More articles by this author Expand All Advertisement Loading ...