Kidney Week

Abstract: SA-PO967

Impact of Victorian Quality Indicator (QI) on Kidney Transplant Wait-Lists for Indigenous and Nonindigenous Australians

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Ling, Rebecca, Department of Renal Medicine, St Vincent’s Hospital, Melbourne, Victoria, Australia

Rebecca Ling, MD

• Davies, Christopher E., Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia

Christopher E. Davies, PhD

• Mark, Tia-Maria, Monash Health Kidney & Pancreas Transplant Unit, Melbourne, Victoria, Australia

Tia-Maria Mark, RN

• McDonald, Stephen P., Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia

Stephen P. McDonald, MBBS, PhD

• Goodman, David J., Department of Renal Medicine, St Vincent’s Hospital, Melbourne, Victoria, Australia

David J. Goodman, MD, PhD

Background

In 2012, Victoria introduced a 6monthly reportable renal QI for proportion of patients waitlisted or pre-emptively transplanted by set time points following start of dialysis. In 2019, renal QI was modified to include patients aged 18-70 at 6 and 12 months after commencing dialysis. We aimed to determine if QI influenced timeliness of placement on kidney transplant waiting list for Victorians, including Indigenous (ATSI; Aboriginal and Torres Strait Islander People) Victorians.

Methods

Dialysis start date, date of waitlisting or pre-emptive transplantation, medical co-morbidities, type of kidney replacement therapy (KRT) for patients aged 18-70 commencing KRT between 2007-2020 was extracted from ANZDATA. Data was divided into three eras and four sub-cohorts. Primary outcome was percentage of patients waitlisted or transplanted at 6, 12 and 24 months from starting dialysis.

Results

Of 25,836 (14.7% ATSI) patients on dialysis, 8,587 (5.7% ATSI) were listed for transplant and 1,103 had pre-emptive transplants by December 2021. A higher proportion of non-ATSI (49%) and ATSI Victorian (31%) patients were waitlisted or had pre-emptive transplants compared to Australians (non-Victorian) (44% and 13% respectively). The proportion of Victorian patients waitlisted or had pre-emptive transplants at all timepoints improved substantially in 2017-2020, compared to 2007-2012. The proportion of Victorian patients waitlisted by 6months improved significantly (aOR 1.85 (1.55-2.21), P<0.001) following QI implementation, but there was no significant change in Australians (non-Victorian). Victorian ATSI patients were three times more likely to be waitlisted or transplanted than ATSI patients in rest of Australia (aOR 3.59 (1.45, 8.87), P = 0.006).

Conclusion

Following introduction of the Victorian QI, the percentage of dialysis patients on waitlist or had pre-emptive transplants at 6 and 12 months increased. Victorian ATSI patients were more likely to be waitlisted than Australian ATSI patients.