American Journal of Kidney Diseases
Volume 60, Issue 3, 2012, Pages 354-359

Kidney transplantation in undocumented immigrants with ESRD: A policy whose time has come? (Article)

Linden E.A. , Cano J. , Coritsidis G.N.*
  • a Division of Nephrology, Elmhurst Hospital Center, 79-01 Broadway, B2-01, Elmhurst, NY 11373, United States, Mount Sinai School of Medicine, New York, NY, United States
  • b Division of Nephrology, Elmhurst Hospital Center, 79-01 Broadway, B2-01, Elmhurst, NY 11373, United States
  • c Division of Nephrology, Elmhurst Hospital Center, 79-01 Broadway, B2-01, Elmhurst, NY 11373, United States, Medicine and Surgery, Mount Sinai School of Medicine, New York, NY, United States

Abstract

Background: In most US states, taxpayers are paying, either directly or indirectly, for years of dialysis therapy for undocumented immigrants with end-stage renal disease who lack resources to pay for care themselves. Living donor transplant is a less expensive long-term alternative, but it is unknown what percentage of these patients have potential living donors. Methods: We conducted a cross-sectional survey of undocumented immigrant patients receiving dialysis at our outpatient center between March and May 2010. Forty-five patients completed the survey. The survey focused on the availability of potential living donors, perceived health status of those donors, and potential recipients' outlook on remaining on dialysis therapy versus receiving a kidney transplant. We gathered demographic and health status data for the survey participants and the 82 documented resident patients receiving care in the same dialysis unit. Results: The average age of our undocumented immigrant patients was 44 years. The undocumented patients were healthier than their legal resident counterparts, with a lower incidence of coronary artery disease (7% vs 33%; P < 0.005) and diabetes mellitus (40% vs 68%; P < 0.005). Approximately half the undocumented immigrants were working when they were surveyed. Of the half who had stopped working, 82% said they would seek work if they had a kidney transplant. 60% had at least one potential kidney donor. Most donors were reported to reside in the United States or Canada. Conclusions: Undocumented immigrants treated with dialysis in the United States are relatively young and healthy, and many have at least one potential living kidney donor. Given the societal cost-savings associated with transplant, we suggest that policy makers should consider extending coverage to pay for living donor transplant for undocumented immigrants with end-stage renal disease. © 2012 National Kidney Foundation, Inc.

Author Keywords

Kidney transplantation Undocumented immigrants

Index Keywords

living donor Tissue Donors health care policy demography Follow-Up Studies human risk assessment hemodialysis patient middle aged diabetes mellitus controlled study health status Tissue and Organ Procurement Cross-Sectional Studies Attitude of Health Personnel United States cross-sectional study Humans Treatment Outcome Waiting Lists male Emigrants and Immigrants female Socioeconomic Factors Renal Dialysis clinical article outpatient department Incidence Outcome Assessment (Health Care) Article Questionnaires adult Kidney Failure, Chronic graft recipient cost control kidney failure Kidney Transplantation renal replacement therapy Health Policy illegal immigrant coronary artery disease policy making

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84865699729&doi=10.1053%2fj.ajkd.2012.05.016&partnerID=40&md5=750d5e3a53036826f53f58c9cddb8cde

DOI: 10.1053/j.ajkd.2012.05.016
ISSN: 02726386
Cited by: 22
Original Language: English