ESRD Patients Who Work Full-Time Are “Much More Likely” To Receive Kidney Transplant

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If those with End-Stage Renal Disease (ESRD) work part time or are unemployed they are substantially less likely to be placed on the Kidney Transplant Waiting List or to even actually receive a new kidney once on the list, according to new research from the University of New Hampshire. Although researchers found that patients who are retired, disabled or are working part time are “much more likely” to be placed on the Kidney Transplant Waiting List than unemployed patients, those who work full time are the most likely to be both added to the transplant list and receive a kidney transplant.

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The leading cause (35%) of kidney rejection, infection, and patient death is non-compliance after Kidney Transplant. A number of factors are considered when deciding to add someone to a transplant list and move forward with the transplant procedure, including whether the patient can afford the post-transplant medical care and medications that are critical for kidney survival and success. Patients that have very limited income suffer higher rates of noncompliance with post-transplant medical care. Hence, some Kidney Transplant Centers may determine that a patient who is unemployed has limited financial resources and subsequently cannot afford adequate medical care for their new kidney.

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Evidence suggests that lack of health insurance can significantly contribute to whether Kidney Transplant access is restricted to patients. Those who are unemployed or even employed part time may not have insurance due to their employment status which can significantly contribute to noncompliance with post-transplant medical care. It is surprising that even those who rely only on Medicare also may experience restricted access to transplant services. According to the researchers, even though Medicare pays for a large portion of the cost of the required immunosuppressant medications, it does not cover non-immunosuppressant prescription drugs that transplant patients may require. As a result, many transplant centers require secondary, private insurance before a patient is considered for the Kidney Transplant Waiting List. Researchers further suggested that transplant centers “could view employment status as a marker of mental and physical health status, education level, and perceived compliance by the patient with post-transplant care.”

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These statistical findings should not be interpreted as being’s beliefs or seen as directly attributable to your personal circumstances. These general findings should be used by you to proactively strategize with your healthcare team to increase your chances of getting placed on the Kidney Transplant Waiting List and ultimately receiving a Kidney Transplant. If you believe that you will likely experience barriers based on your employment situation then check with your Social Worker, Case Manager and Financial Counselor at the Transplant Center to see if they can help you find local, state or national programs that can help with the costs of transplantation and post operative treatment, including needed medication. These findings may be disappointing for some, but DO NOT become discouraged, your focus should be on using this information to best prepare yourself to maneuver within the Kidney Transplant System. has followed up with additional agencies to offer further advice and insight and will share any applicable information received as appropriate.

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"Recipient's Unemployment Restricts Access to Renal Transplantation." Wiley Online Library. Clinical Transplantation: The Journal of Clinical and Transplantation Research

"Newswise." Unemployment Restricts Access to Kidney Transplants

 "Study Shows Unemployed ESRD Patients Are Less Likely to Get Kidney Transplants." Nephrology News and Issues: Renal and Dialysis News and Resources for the Kidney-Care Community.