Listing at non-local transplant centers is associated with increased access to deceased donor kidney transplantation

Katherine Ross-Driscoll, Jonathan Gunasti, Raymond J. Lynch, Allan Massie, Dorry L. Segev, Jon Snyder, David Axelrod, Rachel E. Patzer

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The ability of kidney transplant candidates to travel outside of their usual place of care varies by sociodemographic factors, potentially exacerbating disparities in access. We used Transplant Referral Regions (TRRs) to overcome previous methodological barriers of using geographic distance to assess the characteristics and outcomes of patients listed for kidney transplant at centers in neighboring TRR or beyond neighboring TRRs. Among listed kidney transplant candidates, 20.9% traveled to a neighbor and 5.6% beyond a neighbor. A higher proportion of travelers were White, had some college education, and lived in ZIP codes with lower poverty. Travel to a neighbor was associated with a 7% increase in likelihood of deceased donor transplant (cHR: 1.07, 95% CI: 1.05, 1.09) and traveling beyond a neighbor with a 19% increase (cHR: 1.19, 95% CI: 1.15, 1.24). Travelers had similar rates of living donor transplant and waitlist mortality as patients who did not travel; those who traveled beyond a neighbor had slightly lower posttransplant mortality (HR: 0.91, 95% CI: 0.83, 0.99). In conclusion, the ability to travel outside of the recipient's assigned TRR increases access to transplantation and improves long-term survival. (Figure presented.).

Original languageEnglish (US)
Pages (from-to)1813-1822
Number of pages10
JournalAmerican Journal of Transplantation
Issue number7
StatePublished - Jul 2022


  • Scientific Registry for Transplant Recipients (SRTR)
  • disparities
  • health services and outcomes research
  • kidney transplantation/nephrology
  • patient characteristics
  • registry/registry analysis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)


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