Table 2.
No. of DSAs/State | Transplant Rate | Waiting Time (yr) | Time on Dialysis (yr) | 5-Year Graft Survival (%)a | ||||
---|---|---|---|---|---|---|---|---|
Before | Recently after | Before | Recently after | Before | Recently after | Before | Recently after | |
TN | ||||||||
1 | 4.63 | 6.63 | 0.69 | 1.42 | 1.69 | 2.83 | 34.5 | 81.8b |
2 | 3.94 | 5.61 | 0.47 | 1.47 | 2.62 | 2.93 | 38.8 | 83.4b |
Disparity ratio | 2.02 | 1.19b | 1.74 | 1.11b | 1.58 | 1.09b | 1.12 | 1.02 |
NC | ||||||||
1 | 3.68 | 4.88 | 0.78 | 1.20 | 1.38 | 3.08 | 28.7 | 89.3 |
2 | 5.19 | 8.60 | 0.58 | 2.82 | 1.74 | 4.41 | 31.6 | 82.0b |
Disparity ratio | 1.38 | 2.00 | 1.59 | 2.49 | 1.32 | 1.45 | 1.10 | 1.09 |
PA | ||||||||
1 | 3.65 | 7.79 | 0.79 | 1.71 | 2.02 | 3.16 | 43.3 | 78.8b |
2 | 2.69 | 4.82 | 0.47 | 1.11 | 1.48 | 2.64 | 33.2 | 71.8b |
Disparity ratio | 1.54 | 1.66 | 1.64 | 1.53 | 1.39 | 1.20 | 1.31 | 1.10 |
WI | ||||||||
1 | 3.18 | 7.27 | 0.47 | 2.01 | 1.28 | 3.11 | 30.1 | 89.7 |
2 | 4.61 | 3.54 | 0.47 | 0.83 | 1.01 | 2.09 | 43.3 | 81.8 |
Disparity ratio | 1.73 | 2.04 | 1.19 | 2.46b | 1.40 | 1.50 | 1.44 | 1.10 |
FL | ||||||||
1 | 2.87 | 4.50 | 0.44 | 1.15 | 1.40 | 2.82 | 29.5 | 85.0b |
2 | 2.83 | 6.11 | 0.20 | 1.26 | 1.82 | 3.24 | 38.2 | 87.6b |
3 | 4.13 | 5.51 | 0.74 | 1.39 | 2.35 | 3.18 | 38.1 | 84.4b |
4 | 1.98 | 4.37 | 0.23 | 1.22 | 1.63 | 2.90 | 36.9 | 87.4b |
Disparity ratio | 2.01 | 1.44b | 3.86 | 1.45b | 1.89 | 1.25b | 1.29 | 1.04 |
CA | ||||||||
1 | 5.18 | 22.06 | 0.43 | 2.70 | 1.42 | 5.00 | 39.5 | 88.0b |
2 | 4.97 | 9.16 | 0.18 | 1.62 | 1.16 | 3.94 | 29.6 | 88.6 |
3 | 3.76 | 11.4 | 0.65 | 2.94 | 1.87 | 6.17 | 44.4 | 86.6b |
4 | 3.16 | 7.21 | 0.65 | 2.44 | 2.03 | 3.88 | 38.2 | 82.5b |
Disparity ratio | 2.01 | 3.16 | 4.52 | 2.13 | 1.90 | 1.60 | 1.50 | 1.07 |
NY | ||||||||
1 | 6.81 | 5.66 | 0.45 | 1.44 | 1.41 | 2.51 | 60.5 | 91.4 |
2 | 3.35 | 10.15 | 0.71 | 2.89 | 2.04 | 4.47 | 33.9 | 82.2 |
3 | 6.62 | 9.50 | 0.98 | 2.45 | 2.95 | 5.64 | 38.8 | 76.5b |
4 | 4.18 | 7.40 | 0.78 | 2.26 | 1.60 | 3.16 | 42.9 | 80.3 |
Disparity ratio | 2.49 | 1.99 | 3.28 | 2.17 | 2.50 | 2.27 | 1.78 | 1.19 |
OH | ||||||||
1 | 6.35 | 10.68 | 1.05 | 2.80 | 2.06 | 4.55 | 33.4 | 83.9 |
2 | 5.62 | 4.01 | 0.51 | 1.02 | 1.44 | 2.71 | 26.7 | 76.0b |
3 | 7.37 | 5.00 | 0.34 | 1.48 | 1.18 | 2.90 | 30.6 | 78.9b |
4 | 3.48 | 9.06 | 0.35 | 1.83 | 1.75 | 3.40 | 36.9 | 82.5 |
Disparity ratio | 2.76 | 2.91 | 4.50 | 3.07 | 1.83 | 1.71 | 1.38 | 1.10 |
TX | ||||||||
1 | 2.12 | 6.15 | 0.25 | 1.50 | 1.44 | 3.19 | 31.9 | 80.3 |
2 | 2.73 | 19.9 | 0.35 | 3.42 | 1.44 | 5.24 | 44.0 | 82.6b |
3 | 2.51 | 5.46 | 0.30 | 1.46 | 1.78 | 3.28 | 37.9 | 86.4 |
Disparity ratio | 1.37 | 3.51b | 2.24 | 2.49 | 1.32 | 1.67 | 1.38 | 1.08 |
The change of geographic allocation disparity over time, comparing a 5-year interval prior (1987–1991) to implementation of the Statewide Sharing variance with a recent 5-year time-period (2005–2009). The Statewide Sharing variance was implemented in Florida and Tennessee in 1991 and 1992. The extent of the existing disparity between donor service areas (DSAs) within a state is measured by the disparity ratio. A disparity ratio that equals 1.0 suggests that no geographic disparity exists, while geographic disparity between DSAs increases as the disparity ratio rises above 1.0. Transplant rate calculated as the mean number of transplant candidates per transplant in the period. Waiting time calculated as the median waiting time to transplantation in the period. Time on dialysis is calculated as the median cumulative dialysis time before transplantation in the period. “Before” denotes 1987–1991; “recently after” refers to 2005–2009. DSA, donor service area; TN, Tennessee; NC, North Carolina; PA, Pennsylvania; WI, Wisconsin; FL, Florida; CA, California; NY, New York; OH, Ohio; TX, Texas.
Five-year graft survival significance is adjusted for age, sex, race, panel reactive antibody, diagnosis, insurance, and educational attainment.
Significant difference in disparity ratio between before and recently after implementation of Statewide Sharing variance (P<0.05).