{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T03:00:20Z","timestamp":1773457220089,"version":"3.50.1"},"reference-count":26,"publisher":"Baishideng Publishing Group Inc.","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Transplant"],"abstract":"BACKGROUND<\/jats:p>\n There is no data evaluating the impact of Medicaid expansion on kidney transplants (KT) in Oklahoma.<\/jats:p>\n AIM<\/jats:p>\n To investigate the impact of Medicaid expansion on KT patients in Oklahoma.<\/jats:p>\n METHODS<\/jats:p>\n The UNOS database was utilized to evaluate data pertaining to adult KT recipients in Oklahoma in the pre-and post-Medicaid eras. Bivariate analysis, Kaplan Meier analysis was used to estimate, and cox proportional models were utilized.<\/jats:p>\n RESULTS<\/jats:p>\n There were 2758 pre- and 141 recipients in the post-Medicaid expansion era. Post-expansion patients were more often non-United States citizens (2.3% vs 5.7%), American Indian, Alaskan, or Pacific Islander (7.8% vs 9.2%), Hispanic (7.4% vs 12.8%), or Asian (2.5% vs 8.5%) (P < 0.0001). Waitlist time was shorter in the post-expansion era (410 vs 253 d) (P = 0.0011). Living donor rates, pre-emptive transplants, re-do transplants, delayed graft function rates, kidney donor profile index values, panel reactive antibodies levels, and insurance types were similar. Patients with public insurance were more frail. Despite increased early (< 6 months) rejection rates, 1-year patient and graft survival were similar. In Cox proportional hazards model, male sex, American Indian, Alaskan or Pacific Islander race, public insurance, and frailty category were independent risk factors for death at 1 year. Medicaid expansion was not associated with graft failure or patient survival (adjusted hazard ratio: 1.07; 95%CI: 0.26-4.41).<\/jats:p>\n CONCLUSION<\/jats:p>\n Medicaid expansion in Oklahoma is associated with increased KT access for non-White\/non-Black and non-United States citizen patients with shorter wait times. 1-year graft and patient survival rates were similar before and after expansion. Medicaid expansion itself was not independently associated with graft or patient survival outcomes. Ongoing research is necessary to determine the long-term effects of Medicaid expansion.<\/jats:p>","DOI":"10.5500\/wjt.v14.i3.92981","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T13:14:23Z","timestamp":1722345263000},"source":"Crossref","is-referenced-by-count":1,"title":["Impact of Medicaid expansion on kidney transplantation in the State Oklahoma"],"prefix":"10.5500","volume":"14","author":[{"given":"Hyoshin","family":"Kwon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoya","family":"Sandhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoona","family":"Sarwar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oya M","family":"Andacoglu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2060","published-online":{"date-parts":[[2024,9,18]]},"reference":[{"key":"B1","unstructured":"Cohen RA, Martinez ME, Zammitti EP. Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January-March 2017. 2017. Available from: https:\/\/www.cdc.gov\/nchs\/data\/nhis\/earlyrelease\/insur201708.pdf"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.1491"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2023.1426"},{"key":"B4","unstructured":"OKLAHOMA. Medicaid Expansion. Available from: https:\/\/www.oklahoma.gov\/ohca\/about\/medicaid-expansion\/expansion.html"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.12834"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1177\/000313481808401234"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.00100118"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2016.2067"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2016.07.004"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12748"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06390518"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05279-x"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajt.2023.02.004"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16982"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/s40472-019-0227-z"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaa016"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11030672"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0244492"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfma.2013.10.011"},{"key":"B20","unstructured":"Wiley HR. Kidney Transplant Outcomes in Indigenous People of the Northern Great Plains of the United States. S D Med 2022; 75: 460"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2022.12.008"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2013060658"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.04860420"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14784"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1212321"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-022-03485-7"}],"container-title":["World Journal of Transplantation"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/2220-3230\/full\/v14\/i3\/92981.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/2220-3230\/full\/v14\/i3\/92981.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T13:14:49Z","timestamp":1722345289000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/2220-3230\/full\/v14\/i3\/92981.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,18]]},"references-count":26,"journal-issue":{"issue":"3"},"alternative-id":["92981"],"URL":"https:\/\/doi.org\/10.5500\/wjt.v14.i3.92981","relation":{},"ISSN":["2220-3230"],"issn-type":[{"value":"2220-3230","type":"print"}],"subject":[],"published":{"date-parts":[[2024,9,18]]}}}