Living in Rural Areas Pushes Transplant Patients Down Waiting Lists

Raleigh, N.C. — More than 25,000 people in this country undergo organ transplants each year, and there is a long waiting list, too.

Now, a new study is out that says that where patients live may determine whether they get the transplants they need.

Lisa Chronis has spent years battling kidney disease. When her kidney function failed, she knew an organ transplant was her last hope.

“It's either dialysis or transplant or death. Those are your three options,” said Chronis, who lives in rural New Hampshire.

Her husband, Marc, donated a kidney to her last year, and the transplant was successful. Generally, though, a new study published in the Journal of the American Medical Association shows that living in the country gives someone a lower chance of getting a transplant.

“What we found was that patients who lived in the country were less likely to receive a heart, liver or kidney transplant compared to patients who lived in the city,” said Dr. David Axelrod, who is at the Dartmouth-Hitchcock Medical Center in Lebanon, N.H.

Researchers found that patients in isolated, rural areas were up to 15 percent less likely to be placed on waiting lists for organ transplants and up to 20 percent less likely to receive a heart, liver or kidney transplant than were patients in urban areas.

“When you look at our study, it suggests that the barriers to transplantation [are] not from within the transplant centers, but it's really the barriers to getting in the front door in the first place,” Axelrod said.

Most transplant centers are in urban areas, and patients require several follow-up visits, so transportation can be a problem.

Chronis lived only a 90-minute drive from a transplant center, but she said she knows others have to drive much farther.

“The closer you are, the more likely you are to be compliant with what is necessary,” Chronis said.

Being closer to a center also makes it more likely that there will be close family support, and that helped Chronis decide to proceed with her transplant.

The study showed that once patients made it onto a transplant waiting list, the rates of getting transplants were fairly similar between patients who lived in rural or city areas.