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Rural Residents Get Fewer Organ Transplants: Study
Date:1/8/2008

They're 10% to 20% less likely to undergo heart, liver and kidney transplantation

TUESDAY, Jan. 8 (HealthDay News) -- Americans living in small towns and rural areas are less likely to get organ transplants or be placed on waiting lists for transplants, a new study found.

The study of almost 175,000 potential transplant recipients showed that those living outside metropolitan centers "were 8 percent to 15 percent less likely to be wait-listed and 10 percent to 20 percent less likely to undergo heart, liver and kidney transplantation than patients in urban environments," the report said.

The report suggested two possible explanations for the findings: different patterns of illness in rural areas, or the difficulty of getting on a transplant list.

The second factor is probably more significant, transplant experts said.

"You can't just get listed easily," said Dr. Pang-Yen Fan, director of kidney transplantation at the University of Massachusetts Memorial Medical Center in Worcester. "It requires both medical and surgical evaluation, lots of testing, visits to a transplant center. Many of the patients we see live in a 30- to 50-mile radius of Worcester. For them, coming into Worcester is a big deal. So I don't think the results of the study are surprising."

Lack of sophistication on the part of potential transplant patients and their doctors also plays a role, said Dr. John Fung, director of transplant services at the Cleveland Clinic.

"You can look at the demographics of the [U.S.] population," Fung said. "Fifty percent of the people in metropolitan areas have a high school education or better, compared to one third in rural areas. So there can be a lack of knowledge."

The study, conducted by a group led by Dr. David A. Axelrod, assistant professor of surgery at Dartmouth Medical School in Lebanon, N.H., is published in the Jan. 9/16 issue of the Journal of the American Medi
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