New Study Reveals Disparities In Kidney Transplantation Among Adults With Intellectual And Developmental Disabilities (IDD)
According to new research conducted by The Ohio State University College of Medicine, adults with intellectual and developmental disabilities– also known as IDD– have a lower chance of being evaluated for and receiving a kidney transplant.
This finding is in spite of adults with and without IDD having similar surgical outcomes.
The research team came to this conclusion after conducting a national study of all U.S. adults with end-stage renal disease (ESRD).
They found that adults with IDD had a 54% lower chance of being evaluated for a kidney transplant as opposed to adults without IDD. Additionally, adults with IDD were 62% less likely to actually receive a kidney transplant.
Although, the surgical outcomes of those with IDD who did receive a kidney transplant raise questions about these findings. In these cases, IDD was not identified as a risk factor for perioperative complications, 90-day hospital readmission, or one-year graft rejection.
Since the supply of donor organs cannot keep up with the increasing demand for organ transplants, transplant centers are forced to prioritize certain patients on transplant waitlists.
But, according to Brittany Hand, the study’s lead author, adults with IDD should not be disregarded.
“IDD should not categorically disqualify adults from transplants,” Hand said.
“Our findings show that despite existing protections, like the Americans with Disabilities Act, people with IDD continue to be discriminated against in the organ transplant process. This underscores the need for anti-discrimination initiatives to promote equitable care for this population.”
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For this study, the team evaluated the Medicare data of over 21,300 patients with ESRD. Among this group, 10,692 people had IDD. The team also analyzed the Medicare data of over 1,200 kidney transplant recipients– of which 629 had IDD.
It is important to note that individuals with ESRD in the United States are eligible for Medicare. So, this study allowed for a comprehensive examination of kidney transplant prevalence among adults with IDD as well as without. The researchers also underscored how undergoing organ transplantation is a lifelong and care-intensive endeavor. Plus, just like some adults without IDD, certain adults with IDD may not be strong candidates for organ transplantation.
“However, adults with IDD legally have a right to equal access to evaluation and full, holistic consideration as to whether they would be good transplant candidates,” Hand explained.
So, based on the study’s findings, Hand and her team have called for policies that increase transparency and decrease transplant allocation disparities. They have also advocated for medical professionals to receive anti-discrimination educational resources.
Finally, this study came at a crucial time since the Charlotte Woodward Organ Transplant Discrimination Prevention Act (US House Bill 1235) is under federal consideration.
“There are also now 34 states with laws that prohibit this discrimination, the most recent of which is Michigan– where House Bill 4762 passed in December 2022,” Hand added.
To read the study’s complete findings, which have since been published in JAMA Surgery, visit the link here.
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