Non-Medical Barriers in Access to Kidney Transplantation: Perspectives from Dialysis and Transplant Center Staff Across Four US Regions.

Abstract

Understanding regional variation in early transplant access informs tailored interventions. Two comparable surveys assessed perceived access barriers among dialysis and transplant center staff across New England, New York, U.S. Southeast, and Ohio River Valley (August 2021-October 2023). Among 630 dialysis and 34 transplant staff/centers, dialysis staff most often cited patient disinterest (48.75%), transportation challenges (44.75%), and lack of support (37.87%). Transplant staff cited lack of support (74.35%), non-adherence (52.36%), and disinterest (49.03%). Dialysis staff ranked disinterest highest in New York and Ohio River Valley, and transportation challenges highest in the Southeast and New England. Transplant staff ranked anxiety/fear about the transplant process highest in New York, and lack of support highest elsewhere. Regionally tailored strategies are needed to improve access.