P1550ACCESS TO KIDNEY TRANSPLANTATION IN A NON-PROFIT FACILITY IN GERMANY

Abstract Background and Aims Recent studies demonstrate that US patients undergoing chronic dialysis treatment for end stage renal disease (ESRD) at for-profit facilities had a lower access to kidney transplantation than patients at non-profit facilities. However, even at non-profit facilities only around 20% of patients were placed on the kidney transplantation waiting list. At first glance, this number appears rather low, as kidney transplantation is the only way to curatively treat ESRD. We want to compare these figures with a recently performed survey in Germany. Method We analyzed the status of transplant evaluation in the largest non-profit facility in Germany, the Kuratorium für Dialyse und Nierentransplantation e.V. (kfh, www.kfh.de). In total, the transplant status was assessed in 16,705 patients. Results Out of these only 19.4% of patients (n=3241) are on the kidney transplant waiting list, comparable to recently performed US studies. The reason why patients are not waitlisted are multifaceted as seen in attached figure. Due to severe comorbidities about 50% are considered too sick to benefit from transplantation, in turn representing the complex and high multi-morbidity of patients with ESRD. On the other hand, approximately 10% of dialysis patients actively decline listing for renal transplantation at least at some point. Conclusion We conclude that further research is needed to identify and break the mechanisms behind the low likelihood for access to kidney transplantation waiting list. Patients with documented transplant status for kidney transplantation (KTx) in a German non-profit dialysis facility n=16,705 Of these…. n (%) No obvious contraindication against access to KTx on the deceased KTx waiting list 3,241 (19) on the active waiting list 1,848 (11) currently not transplantable 1,393 (8) under evaluation to be placed on the waiting list 3,418 (21) listing for transplantation declined by patient 1,623 (10) Access to KTx not possible access to transplantation not possible due to comorbidities (medical reasons) 8,051 (48) removed from waiting list due to medical reasons 372 (2) Distribution of patients with surveyed transplant status in the largest non-profit dialysis facility (kfh, www.kfh.de) in Germany