Non-Medical Barriers in Access to Kidney Transplantation: Perspectives from Dialysis and Transplant Center Staff Across Four US Regions

Abstract

Understanding regional variation in early transplant access can inform tailored interventions. We surveyed dialysis and transplant center staff across New York, New England, Southeast, and Ohio River Valley (Aug 2021-Oct 2023) to assess perceived access barriers. Among 630 dialysis and 34 transplant staff, dialysis staff most often cited patient disinterest (48.8%), transportation challenges (44.8%), and lack of support (37.9%), while transplant staff cited lack of support (74.4%), non-adherence (52.4%), and disinterest (49%). Regional differences emerged: anxiety/fear about the transplant process ranked highest in New York, while lack of support ranked highest elsewhere. Awareness of racial differences in transplant evaluation access was greater nationally than locally, with regional differences. Findings underscore the need for regionally tailored strategies to improve access.