{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T03:34:02Z","timestamp":1790048042199,"version":"4.0.1"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2023,4,1]]},"abstract":"\n Importance<\/jats:title>\n Improving equity in organ transplant access for people with intellectual and developmental disabilities (IDD) is a topic of social discourse in mainstream media, state legislation, and national legislation. However, few studies have compared evaluation rates, transplant rates, and outcomes among adults with and without IDD.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare rates of kidney transplant and transplant-specific outcomes between propensity\u2013score matched groups of adults with end-stage kidney disease (ESKD [also referred to as end-stage renal disease (ESRD)]) with and without co-occurring IDD.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study included all Medicare inpatient and outpatient standard analytical files from 2013 through 2020. A total of 1\u202f413\u202f655 adult Medicare beneficiaries with ESKD were identified. Propensity\u2013score matching was used to balance cohorts based on age, sex, race, follow-up duration, and Charlson Comorbidity Index. The matched cohorts consisted of 21\u202f384 adults with ESKD (10\u202f692 of whom had IDD) and 1258 kidney transplant recipients (629 of whom had IDD). Data were analyzed between June 1, 2022, and August 1, 2022.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n IDD.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Evaluation for kidney transplant, receipt of kidney transplant, perioperative complications, readmission, mortality, graft rejection, and graft failure.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of the 21\u202f384 propensity\u2013score matched adults with ESKD, the median (IQR) age was 55 (43-65) years, 39.2% were male, 27.4% were Black, 64.1% were White, and 8.5% identified as another race or ethnicity. After propensity score matching within the ESKD cohort, 633 patients with IDD (5.9%) received a kidney transplant compared with 1367 of adults without IDD (12.8%). Adults with IDD were 54% less likely than matched peers without IDD to be evaluated for transplant (odds ratio, 0.46; 95% CI, 0.43-0.50) and 62% less likely to receive a kidney transplant (odds ratio, 0.38; 95% CI, 0.34-0.42). Among matched cohorts of kidney transplant recipients, rates of perioperative complications, readmission, and graft failure were similar for adults with and without IDD.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n Using the largest cohort of adult kidney transplant recipients with IDD to date, the study team found that rates of evaluation and transplant were lower despite yielding equivalent outcomes. These data support consideration of adults with IDD for kidney transplant and underscore the urgent need for antidiscrimination initiatives to promote the receipt of equitable care for this population.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamasurg.2022.7753","type":"journal-article","created":{"date-parts":[[2023,2,15]],"date-time":"2023-02-15T11:02:52Z","timestamp":1676458972000},"page":"386","source":"Crossref","is-referenced-by-count":18,"title":["Comparing Kidney Transplant Rates and Outcomes Among Adults With and Without Intellectual and Developmental Disabilities"],"prefix":"10.1001","volume":"158","author":[{"given":"Brittany N.","family":"Hand","sequence":"first","affiliation":[{"name":"School of Health and Rehabilitation Sciences, The Ohio State University, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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A woman with down syndrome has fought for organ transplant anti-discrimination legislation for years; now, it\u2019s been proposed, and named after her. Accessed January 9, 2023. https:\/\/www.forbes.com\/sites\/allisonnorlian\/2021\/01\/04\/a-woman-with-down-syndrome-has-fought-for-organ-transplant-anti-discrimination-legislation-for-years-now-its-been-proposed-and-named-after-her\/"},{"key":"soi220114r22","unstructured":"Roppolo? M. They say their children are being denied transplants because of their disabilities. A new federal law may help change that. Accessed January 9, 2023. https:\/\/www.cbsnews.com\/news\/organ-transplants-discrimination-disability-rights\/"},{"key":"soi220114r23","unstructured":"Rouan? R. Bill would ban \u201cheartless\u201d discrimination against people with disabilities who need organs. 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