RaDIANT Study Seeks to Improve Access to Kidney Transplants

The Emory Transplant Center has some of the best kidney transplant patient and graft survival rates of any center in the country. Yet too few end-stage renal disease (ESRD) patients, especially those who have already started dialysis, are able to take advantage of these benefits.

In order to combat this, Emory Transplant Center has been participating in a research study, the RaDIANT (Reducing Disparities in Access to Kidney Transplantation) Study, to better understand the inequalities related to kidney transplant access among patients, especially those in the early stages of the transplant process.

Research efforts have been co-led by Emory Transplant Center principal investigators of the study, Dr. Stephen Pastan, medical director of the Kidney and Pancreas Transplant Program and chair of the Southeastern Kidney Transplant Coalition, and Dr. Rachel Patzer, epidemiologist and director of the Transplant Health Services and Outcomes Program.

In 2016, the Emory Transplant Center received a 5-year, $2.6 million award from the National Institutes of Minority Health and Health Disparities to fund the RaDIANT Study. The goal of the study was to ensure equity among patients being referred for kidney transplant and in every step of the transplant process, including referral, medical evaluation, waitlisting, and transplantation. The work targeted Georgia dialysis facilities, with an emphasis on improving patient access through an educational and outreach program.

The study increased referrals and improved racial equity in kidney transplant referral for patients on dialysis.1 Several years later, after its success in Georgia, the RaDIANT intervention was expanded to North Carolina and South Carolina dialysis facilities. Early results showed that it was also effective regionally in improving rates of referral for kidney transplant.

More Data is Needed About Barriers to the Kidney Transplant Process

Despite successes, the Southeast continues to have high rates of end-stage kidney disease while also having low kidney transplant rates and significant differences in access to transplants.2 The RaDIANT Regional Study has focused on characterizing these disparities in the Southeast in order to develop and implement interventions to increase equity in access.

The Emory Transplant Center research team published a study earlier in 2020 about barriers to patient referral for kidney transplant. The study found that those barriers were not always the same as the barriers that exist at later steps in the process, such as medical evaluation at a transplant center.

Currently, Patzer, Pastan, and the team are expanding their research efforts to the national level with the RaDIANT National Study. In 2019, the study received a four-year, $2.1 million award from the National Institute of Diabetes and Digestive and Kidney Diseases.

The study’s investigators aim to collect surveillance data on early steps in the kidney transplant process from more than 30 transplant centers across three regions: New England, New York, and the Ohio River Valley. They will also conduct focus groups and surveys with patients and clinical providers.

Adds Dr. Pastan, “This study will seek to understand regional barriers to access transplants. It will explore how these barriers may vary across the United States and inform future interventions to improve equity in transplant access.”

About Emory Transplant Center

Emory Transplant Center is a leader in clinical excellence and in pioneering new transplant therapies. We offer cutting-edge technology and superior outcomes in heart transplant, kidney transplant, liver transplant, lung transplant surgery, and pancreas transplant surgery.

Our patients come from all over the nation for our high level of expertise and proven patient outcomes. We are proud to be ranked among the top 15 transplant programs in the nation and have performed more than 10,000 transplants to date.

To learn more about the Emory Transplant Center, visit emoryhealthcare.org/transplant or call 855-366-7989.

1. Patzer, R. E., Paul, S., Plantinga, L., Gander, J., Sauls, L., Krisher, J., … Pastan, S. O. (2017). A Randomized Trial to Reduce Disparities in Referral for Transplant Evaluation. J Am Soc Nephrol, 28(3), 935-942. doi:10.1681/asn.2016030320
   
   
2. United States Renal Data System. 2020 USRDS Annual Data Report: Epidemiology of kidney disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, 2020.
   
   
3. Patzer, R. E., McPherson, L., Wang, Z., Plantinga, L. C., Paul, S., Ellis, M., . . . Pastan, S. O. (2020). Dialysis facility referral and start of evaluation for kidney transplantation among patients treated with dialysis in the Southeastern United States. Am J Transplant, 20(8), 2113-2125. doi:10.1111/ajt.15791