Journal of Epidemiology and Community Health, Vol 50, 447-450
The admission of Asian patients to intensive therapy units and its implications for kidney donation: a preliminary report from Coventry, UK
C Exley, J Sim, NG Reid, L Booth, S Jackson and N West
School of Health and Social Sciences, Coventry University.
OBJECTIVE: To determine the relative admission rates of Asian and non-
Asian patients to intensive therapy units (ITUs) in Coventry and to explore
the implications of these rates for the transplantation of organs to Asian
people. DESIGN: Examination of 1991 census data and a retrospective review
of ITU admissions books. Data were collected on ethnic background,
presenting diagnosis, and clinical outcome for each admission. SETTING: The
three ITUs in Coventry. PATIENTS: All admissions to the ITUs from 1990-93
inclusive. RESULTS: Asian patients were admitted to ITUs disproportionately
to their numbers in the Coventry population. Members of the Asian community
were less than half as likely to be admitted to an ITU (p < 0.001) and
more likely to die while there (p = 0.007) than members of the non-Asian
population in Coventry. The proportions of patients referred to the
transplant unit and the rates of subsequent donation do not seem to differ
significantly for Asian and non-Asian patients (p = 0.26 in both cases).
CONCLUSIONS: There are clear implications for the availability of cadaveric
kidney transplantation to Asian patients, given that few kidneys from
non-Asian donors are histocompatible with Asian recipients. Indeed, in
Asians, promotion of living related donation may be more effective in
countering the organ shortfall than efforts to increase consent to
cadaveric transplantation. However, it may be valuable to investigate any
patterns of morbidity or social or cultural factors that might explain the
initial low admissions rates to ITUs for Asian patients.
Copyright © 1996 by the Journal of Epidemiology and Community Health
