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Understanding barriers to transplantation and the impact of COVID-19

Dr. Shaifali Sandal is a transplant nephrologist and assistant professor at the McGill University Health Center, Montreal, Canada. Her research focuses on improving living donor kidney transplantation (KT) and re-transplantation rates.

In patients with kidney failure, transplantation is usually the best therapeutic option. It offers better survival rates and quality of life than dialysis. Economic research has also shown that kidney transplantation is cost-effective for health care systems. So, improving access to kidney transplantation and increasing transplantation rates are global priorities for clinical settings, research, and policymaking.

“Current efforts to increase kidney transplantation have primarily focused on patient-level interventions and have missed other levels of practice and levers of change,” says Dr. Shaifali Sandal. “My research focuses on understanding the health systems that govern kidney transplantation to better inform interventional work. By improving understanding of current systems, I hope to inform multilevel interventional work and address disparities in access to increase kidney transplantation.”

In her talk at WCN’22, Dr. Sandal will discuss the findings of an international survey on COVID-19 and KT and explain how vulnerable transplantation is to the baseline health system resources. “We have found that in the initial days of the pandemic, the impact on transplantation was much greater in lower-income countries, independent of the COVID-19 burden. I will also describe immunosuppression practices, and I hope to generate some consensus.”

She continues: “The big research question is to understand how current systems are perhaps delivering care inequitably to patients. Using mixed methods, I hope to demonstrate this. I also want to understand the system vulnerabilities that can influence the field in countries other than Canada and the US. The COVID-19 pandemic provided a real-world scenario of assessing this.”

Dr. Sandal and her team are conducting a follow-up survey to examine if the recovery of KT following the pandemic is also influenced by baseline health system vulnerabilities.

Dr. Shaifali Sandal: “International Survey on Covid-19”, Theme Symposium on “Increasing Access to Transplantation Worldwide. Joint session with TTS”, Sunday 27 February, 21:30-22:30 hrs Kuala Lumpur (Malaysia) time: https://cm.theisn.org/cmPortal/searchable/WCN2022/config/normal#!sessiondetails/0000015550_0

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