Abstract: TH-PO862
Improving Transplantation Equity in Australia: The National Indigenous Kidney Transplantation Taskforce
Session Information
- Race, Ethnicity, and Gender in Kidney Health and Care
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Hughes, Jaquelyne T., Flinders University College of Medicine and Public Health, Adelaide, South Australia, Australia
- Cundale, Katie, Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
- McDonald, Stephen P., Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
Background
In Australia, Aboriginal and Torres Strait Islander people experience inequitably high rates of kidney failure yet significantly lower rates of transplantation. The Australian Government recognised this disparity and funded the establishment of the National Indigenous Kidney Transplantation Taskforce (NIKTT). The NIKTT is the first of its kind: in Australia, and other colonised countries, little coordinated effort has been made from government-led initiatives to truly change transplantation access and outcomes for Indigenous peoples.
Methods
The NIKTT was created to drive the development and implementation of initiatives that targeted gaps in access to care for Aboriginal and Torres Strait Islander kidney patients, facilitating improved transplant waitlisting. The NIKTT did this by:
(1) implementing enhanced clinical data collection on waitlisting;
(2) trialling a range of locally developed and led service models; and
(3) evaluating cultural bias initiatives in Australia.
To best inform Taskforce action, the NIKTT created a national network of Aboriginal and Torres Strait Islander consumers and established Indigenous Reference Groups at transplant units around the country.
Results
Over three years, the NIKTT found that: (1) While there was an increase in the number of Aboriginal and Torres Strait Islander people activated on the waitlist, waitlisting and transplantation remain inequitable in Australia. Data suggests that late initiation of work up, along with clinician-perceived barriers such as obesity and non-adherence, could contribute to this disparity; (2) Models of care that work best to increase the rate of placement on the waitlist include outreach assessment clinics, patient navigator programs, Indigenous Reference Groups, and context-specific educational resources; and (3) Increasing the Aboriginal and Torres Strait Islander renal workforce, tailoring models of care to local contexts, and improving institutional safety through policies and funding could meaningfully improve the safety of services.
Conclusion
The development of a national Taskforce was critical to provide a focal point to drive real change in Australia. Targeted clinical, policy, and consumer activity within the NIKTT has confirmed increased waitlisting, but further time and funding is needed to appreciate the impact on transplantation and outcomes.
Funding
- Government Support – Non-U.S.