Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients

M. E. McEnhill, J. L. Brennan, E. Winnicki, M. M. Lee, M. Tavakol, A. M. Posselt, P. G. Stock, A. A. Portale

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Kidney transplantation is the optimal treatment for children with end-stage renal disease. For children with undocumented immigration status, access to kidney transplantation is limited, and data on transplant outcomes in this population are scarce. The goal of the present retrospective single-center study was to compare outcomes after kidney transplantation in undocumented children with those of US citizen children. Undocumented residency status was identified in 48 (17%) of 289 children who received a kidney transplant between 1998 and 2010. In undocumented recipients, graft survival at 1 and 5 years posttransplantation was similar, and mean estimated glomerular filtration rate at 1 year was higher than that in recipients who were citizens. The risk of allograft failure was lower in undocumented recipients relative to that in citizens at 5 years posttransplantation, after adjustment for patient age, donor age, donor type, and HLA mismatch (p < 0.04). In contrast, nearly one in five undocumented recipients who reached 21 years of age lost their graft, primarily because they were unable to pay for immunosuppressive medications once their state-funded insurance had ended. These findings support the ongoing need for immigration policies for the undocumented that facilitate access to work-permits and employment-related insurance for this disadvantaged group.

Original languageEnglish (US)
Pages (from-to)1827-1833
Number of pages7
JournalAmerican Journal of Transplantation
Volume16
Issue number6
DOIs
StatePublished - 2016

Fingerprint

Emigration and Immigration
Pediatrics
Kidney
Kidney Transplantation
Insurance
Transplants
Tissue Donors
Vulnerable Populations
Graft Survival
Licensure
Immunosuppressive Agents
Internship and Residency
Glomerular Filtration Rate
Chronic Kidney Failure
Allografts
Transplant Recipients
Population

ASJC Scopus subject areas

  • Immunology and Allergy
  • Medicine(all)
  • Pharmacology (medical)
  • Transplantation

Cite this

McEnhill, M. E., Brennan, J. L., Winnicki, E., Lee, M. M., Tavakol, M., Posselt, A. M., ... Portale, A. A. (2016). Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients. American Journal of Transplantation, 16(6), 1827-1833. https://doi.org/10.1111/ajt.13683

Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients. / McEnhill, M. E.; Brennan, J. L.; Winnicki, E.; Lee, M. M.; Tavakol, M.; Posselt, A. M.; Stock, P. G.; Portale, A. A.

In: American Journal of Transplantation, Vol. 16, No. 6, 2016, p. 1827-1833.

Research output: Contribution to journalArticle

McEnhill, ME, Brennan, JL, Winnicki, E, Lee, MM, Tavakol, M, Posselt, AM, Stock, PG & Portale, AA 2016, 'Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients', American Journal of Transplantation, vol. 16, no. 6, pp. 1827-1833. https://doi.org/10.1111/ajt.13683
McEnhill ME, Brennan JL, Winnicki E, Lee MM, Tavakol M, Posselt AM et al. Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients. American Journal of Transplantation. 2016;16(6):1827-1833. https://doi.org/10.1111/ajt.13683
McEnhill, M. E. ; Brennan, J. L. ; Winnicki, E. ; Lee, M. M. ; Tavakol, M. ; Posselt, A. M. ; Stock, P. G. ; Portale, A. A. / Effect of Immigration Status on Outcomes in Pediatric Kidney Transplant Recipients. In: American Journal of Transplantation. 2016 ; Vol. 16, No. 6. pp. 1827-1833.
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