Christine Park|Mandisa?Maia Jones|Samantha Kaplan|Felicitas L. Koller|Julius Wilder|L. Ebony Boulware|Lisa M. McElroy
A scoping review of inequities in access to organ transplant in the United States
Duke University|Cornell University|Duke University|University of Mississippi|Duke University|Duke University|Duke University
organ transplant preferred treatment endstage organ disease yet majority patients endstage organ disease never placed transplant waiting list limited access transplant waiting list combined scarcity organ pool result 100000 deaths annually united states patients face unique barriers referral acceptance organ transplant based social determinants health patients disenfranchised groups suffer disproportionately lower rates transplantation objective review literature describing disparities access organ transplantation based social determinants health integrate existing knowledge guide future researchwe conducted scoping review literature reporting disparities access heart lung liver pancreas kidney transplantation based social determinants health race income education geography insurance status health literacy engagement included studies categorized based steps along transplant care continuum referral transplant transplant evaluation selection living donor identificationevaluation waitlist outcomesour search generated 16643 studies 227 included final review 34 focused disparities referral transplantation among patients chronic organ disease 82 transplant selection processes 50 living donors 61 waitlist management total 15 studies involved thoracic organs heart lung 209 involved abdominal organs kidney liver pancreas three involved multiple organs racial ethnic minorities women patients lower socioeconomic status groups less likely referred evaluated added waiting list organ transplant quality data describing disparities across transplant literature variable overwhelmingly focused kidney transplantthis review contextualizes quality data identifies seminal work organ reports gaps literature future research disparities organ transplantation focus future work investigate association social determinants health access organ transplant waiting list focus prospective analyses assess interventions improve health equity