Ottawa study shows unequal access to kidney transplants across Ontario

CTV Ottawa: Kidney wait lists vary by region Access to life-saving transplants depends on where you live. CTV’s Joanne Schnurr explains.

Where you live in Ontario seems to determine your access to a kidney transplant.

Researchers in Ottawa havediscoveredthat our "universal" health care system may not be so universal after all.

You'd expect the rates for kidney transplants to vary greatly in the United States, depending on where you live.  And, in fact, research shows that's exactly the case.

But here in Ontario, where we all supposedly have access to the same health care system, researchers were surprised by their findings.

It has been years since Jim Ward stepped foot in the hemodialysis unit at the Ottawa Hospital.

“It’s not the place you want to be,” he said, as he stepped through the door, “You want to do everything you can not to be here.”

For him, that meant a kidney transplant on Valentine’s Day in 2001, thanks to his brother John, who lived in Liverpool, England.

“How do you thank somebody for giving you a kidney,” he says, as he showed off his scar.

It is the gift of life but a team of Ottawa researchers has discovered that gift is not universally accessible across Ontario.

“I think it's very important (to have universal access) because kidney transplantation is the treatment of choice for patients with end stage renal failure,” says Dr. Greg Knoll, the head of the Division of nephrology at The Ottawa Hospital and senior author of a study published today in the American Journal of Transplantation, “We want to make sure across the province that patients have similar access to that treatment.”

The ten-year study looked at 23-thousand chronic dialysis patients in 27 kidney care programs throughout Ontario between 2003 and 2013.

It found that access varied a lot; from a 7.4% chance of getting one in those ten years to a 31.4% chance.

And when researchers considered only those patients most eligible (aged 18 to 50 with no history of cancer, diabetes or heart disease) access varied even more from 32.5% to 82.7%.

This is the first study that compares transplant rates within Ontario.  There has been another older study that compared rates within Canada, with surprising results as well.  That study found that kidney chronic dialysis patients were three times more likely to get a kidney transplant within Alberta than they were compared to Ontario.

The researchers won't say which Ontario centres were the best; only that 6 performed above the average and six below. But the hope is that this information will help even the playing field for dialysis patients across Ontairo.

“That's an important step now for policymakers and for governments that have responsibility for renal care,” says Dr. Knoll, “to look at the differences, who is performing better, and to see if there are best practices to share across the province.”

For Jim Ward, no longer tied to a dialysis machine, it is something he wishes for others.

“Everyone should have that same access,” he says, “and I think in the long run, it would be more economical for everybody.”

In Ontario, transplant numbers have been improving.  In fact, the Ottawa Hospital did a record 115 kidney transplants last year. And they are already off to a busy start this year with two in the first week of January.