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Equitable access to kidney transplants for Aboriginal and Torres Strait Islander people in Australia

First Nations peoples in Australia face systemic inequities in access to kidney transplantation. The National Indigenous Kidney Transplant Taskforce was established to address these. It has provided support to clinicians to implement and evaluate innovative practices and developed strategies to address biases in the structures and models of care that create barriers to wait-listing.

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Fig. 1: Notional steps to receipt of a deceased donor kidney transplant.

References

  1. ANZDATA Registry. Kidney failure in Aboriginal and Torres Strait Islander Australians. in ANZDATA Registry: 45th Annual Report (ed. ANZDATA Registry) Ch. 10 (ANZDATA Registry, Adelaide, 2022).

  2. Yeates, K. E. et al. Indigenous people in Australia, Canada, New Zealand and the United States are less likely to receive renal transplantation. Kidney Int. 76, 659–664 (2009).

    Article  PubMed  Google Scholar 

  3. Devitt, J. et al. Difficult conversations: Australian Indigenous patients’ views on kidney transplantation. BMC Nephrol. 18, 310 (2017).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Anderson, K. et al. If you can’t comply with dialysis, how do you expect me to trust you with transplantation? Australian nephrologists’ views on indigenous Australians’ ‘non-compliance’ and their suitability for kidney transplantation. Int. J. Equity Health 11, 21 (2012).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Majoni, S. W., Dole, K., Hughes, J. T. & Pain, C. Review of current pathways to wait-listing for kidney transplantation for Aboriginal and Torres Strait Islander peoples with end-stage kidney disease in the Top End of Northern Australia. Aust. Health Rev. 45, 185–193 (2021).

    Article  PubMed  Google Scholar 

  6. Cass, A. et al. Sharing the true stories: improving communication between Aboriginal patients and healthcare workers. Med. J. Aust. 176, 466–470 (2002).

    Article  PubMed  Google Scholar 

  7. Khanal, N., Lawton, P. D., Cass, A. & McDonald, S. P. Disparity of access to kidney transplantation by Indigenous and non-Indigenous Australians. Med. J. Aust. 209, 261–266 (2018).

    Article  PubMed  Google Scholar 

  8. Henry, B. R., Houston, S. & Mooney, G. H. Institutional racism in Australian healthcare: a plea for decency. Med. J. Aust. 180, 517–520 (2004).

    Article  PubMed  Google Scholar 

  9. Productivity Commission. Closing the Gap annual data compilation report July 2023 (Australian Government, 2023).

  10. Kelly, J., Dent, P., Owen, K., Schwatzkopff, K. & O’Donnell, K. Cultural bias Indigenous kidney care and kidney transplantation report (Lowitja Institute, 2022).

  11. Department of Health. Draft national strategy for organ donation, retrieval and transplantation (Australian Government, 2022).

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Acknowledgements

K.J.O. is a Kaurna, Narungga and Ngarrindjeri woman; M.D. is a Paakantyi woman; J.T.H. is a Torres Strait Islander woman (Wagadagam). S.P.M. and K.C. are non-Indigenous. The National Indigenous Kidney Transplant Taskforce was funded by a grant from the Australian Government Department of Health to the Transplantation Society of Australia and New Zealand. It was hosted by the South Australia Health and Medical Research Institute. J.T.H. holds an Australian National Health and Medical Research Council Emerging Leadership Investigator Grant (GNT 1174758), which supported her NHMRC leadership role. 

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Correspondence to Stephen P. McDonald.

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McDonald, S.P., Cundale, K., Owen, K.J. et al. Equitable access to kidney transplants for Aboriginal and Torres Strait Islander people in Australia. Nat Rev Nephrol 19, 751–752 (2023). https://doi.org/10.1038/s41581-023-00780-3

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