Impact of Medicaid expansion on kidney transplantation in the State Oklahoma

Table 1 Statistical analysis of pre-and post-Medicaid expansion in adult kidney transplant recipients for the state of Oklahoma

Variables	Before medicaid expansion (n = 2758)	After medicaid expansion (n = 141)	P value
Recipient age, median (IQR)	53.0 (21.0)	51.0 (22.0)	0.3999c
Gender
Female	1089 (39.5)	56 (39.7)	0.9563
Male	1669 (60.5)	85 (60.3)
Recipient BMI, Median (IQR)	27.8 (7.6)	28.4 (8.0)	0.1549c
Race
White	1708 (61.9)	75 (53.2)	< 0.0001
Black	531 (19.3)	22 (15.6)
Amer Ind/Alaska Native/Pacific Islander	215 (7.8)	13 (9.2)
Hispanic	204 (7.4)	18 (12.8)
Asian	68 (2.5)	12 (8.5)
Multiracial	32 (1.2)	1 (0.7)
Citizenship at transplant
United States citizen	2696 (97.8)	133 (94.3)	0.0188a
Non-United States citizen	62 (2.3)	8 (5.7)
ESRD diagnosis
Other	1423 (51.8)	85 (60.3)	0.0646
Diabetes	778 (28.3)	26 (18.4)
Hypertension	546 (19.9)	30 (21.3)
History of a previous kidney transplant	306 (11.1)	14 (9.9)	0.6665
Recipient pretransplant dialysis	2303 (83.9)	110 (78.0)	0.0673
Initial calculated EPTS
< 20%	2086 (75.6)	61 (43.3)	< 0.0001
≥ 20%	672 (24.4)	80 (56.7)
PRA, median (IQR)	0.0 (27.0)	0.0 (37.0)	0.3133c
Recipient functional status at transplant
Able to carry on normal activity and to work. No special care needed	2158 (80.6)	11 (80.9)	0.5848
Unable to work; able to live at home and care for most personal needs; varying amount of assistance needed	499 (18.6)	27 (19.2)
Unable to care for self; requires equivalent of institutional or hospital care; diseases may be progressing rapidly	20 (0.8)	0 (0.0)
Recipient functional status-most recent at follow-up
Able to carry on normal activity and to work. No special care needed	1025 (80.8)	116 (82.3)	0.1781
Unable to work; able to live at home and care for most personal needs; varying amount of assistance needed	197 (15.5)	24 (17.0)
Unable to care for self; requires equivalent of institutional or hospital care; diseases may be progressing rapidly	46 (3.6)	1 (0.7)
Total days on waiting list/including inactive time, median (IQR)	410.0 (683.0)	253.0 (621.0)	0.0011c
Donor type
Deceased donor	2098 (76.1)	111 (78.7)	0.4705
Living donor	660 (23.9)	30 (21.3)
DCD donor	469 (22.4)	33 (29.7)	0.0708
Deceased donor kidney biopsy	681 (32.5)	46 (41.4)	0.0497
Donor kidney glomerulosclerosis, %
≤ 20	709 (98.6)	52 (100.0)	1.0000a
> 20	10 (1.4)	0 (0.0)
HLA mismatch level
0	199 (7.2)	9 (6.4)	0.0161
1	70 (2.5)	1 (0.7)
2	203 (7.4)	7 (5.0)
3	439 (16.0)	21 (15.0)
4	678 (24.7)	54 (38.6)
5	800 (29.1)	31 (22.1)
6	362 (13.2)	17 (12.1)
Delayed graft function	408 (14.8)	27 (19.2)	0.1578
KDPI
Low < 20%	648 (31.0)	40 (36.0)	0.4063
Moderate 20%-85%	1375 (65.7)	69 (62.2)
High > 85%	69 (3.3)	2 (1.8)
KDPI, median (IQR)	34.0 (40.0)	34.0 (50.0)	0.9930c
Share type
Local	2437 (88.4)	68 (48.2)	< 0.0001
Regional	101 (3.7)	24 (17.0)
National	220 (8.0)	49 (34.8)
Kidney cold ischemic time (hours), median (IQR)	12.0 (12.5)	16.0 (12.9)	< 0.0001c
Rejection within 6 months	176 (7.5)	9 (16.4)	0.0344a
Post TX
Recipient primary insurance at transplant
Private insurance	835 (30.3)	47 (33.3)	0.5142b
Public insurance	1921 (69.7)	94 (66.7)
Other	2 (0.1)	0 (0.0)
Working for income	876 (34.7)	57 (42.2)	0.0752

^aP for Fisher exact test.

^bP for Monte Carlos exact test.

^cP for Wilcoxon Rank sum test.

IQR: Inter quartile range; BMI: Body mass index; ESRD: End Stage Renal Disease; EPTS: Estimated Post Transplant Survival; PRA: Panel Reactive Antibodies; DCD: Donation after Cardiac Death; HLA: Human Leukocyte Antigens; KDPI: Kidney Donor Profile Index; TX: Transplant.