Each March, National Kidney Month brings national attention to the millions of Americans living with kidney disease. For Rachel Patzer, PhD, MPH, and the Transplant Research for Enhancing Access Team (TREAT), however, the month is more than a time to raise awareness: it’s an opportunity to reflect on how research, policy and advocacy work together to transform patient lives.
As President and CEO of Regenstrief Institute, a research scientist and faculty member in the Department of Surgery, Patzer has dedicated her career to expanding access to transplant care for patients living with kidney disease.
"When I was a master's student in Georgia, I discovered the state had the lowest rates of kidney transplantation in the entire nation," Patzer said. "I remember being driven by that question — why? My mentor encouraged me to apply research methods and dig into the data to understand what barriers patients were facing and why access to transplant care was so limited."
Patzer has helped shift transplantation toward a population health model, using data to shape quality improvement, policy and expand access to care. Currently, she and her team are focused on increasing living donor transplant access and implementing quality improvement strategies within health systems to ensure more patients have a meaningful opportunity to receive a transplant.
"Our team focuses on improving access to kidney transplantation at every step before surgery, from referral to evaluation to getting on the waiting list," said Patzer. "New areas we are researching now include studying the new Increasing Organ Transplant Access (IOTA) payment model and working with transplant centers to improve their processes, reduce closed referrals and expand living donor access. Our goal is to implement quality improvement strategies that give more patients, particularly younger adults and those facing socioeconomic barriers, a better chance of receiving a transplant."
The Transplant Research for Enhancing Access (TREAT) team is a group of clinicians, researchers and patient advocates who are dedicated to improving the process of receiving transplants for patients.
"Our team conducts research, especially on the process of transplant referral and evaluation," said Katie Ross-Driscoll, PhD, MPH, a Department of Surgery faculty member, Regenstrief research scientist and TREAT team member. "We disseminate our findings to transplant centers and create data tools for them to improve their processes. We then disseminate our research into communities to help patients navigate the process more effectively."
Although the TREAT team has made substantial strides in transplant access research, there are still barriers that exist, preventing patients from accessing transplant care.
"For patients living in communities where access to transplant care is poor, they don’t have an equal opportunity to navigate the process," said Ross-Driscoll. "They might not get a referral, so they might not have a place to start. They might face barriers along the way in trying to finish the evaluation requirements, or they might not be selected for listing at the same rate as patients in other communities."
Socioeconomic disparities, limited transportation and long distances to transplant centers continue to restrict access, driving lower rates of kidney transplantation.
"Our team is trying to understand how patients move through the transplant process," said Patzer. "We’re trying to understand what slows them down, what those barriers are and how can we intervene."
In understanding the transplant process, the TREAT team is committed to advocating for policy change, which would directly benefit patients with kidney disease and those pursuing a transplant.
"There’s really no area of healthcare in the United States where policy and the decisions of policy makers and regulators carry more weight than in transplant care," said Adam Wilk, PhD, a Department of Surgery faculty member, Deputy Director of TREAT and Regenstrief research scientist. "We work regularly with policymakers, advocates and health system leaders to understand how national and state policies influence the behavior of transplant centers, dialysis units and patients navigating the transplant process. By sharing what we learn about where patients struggle or succeed, we help inform their efforts so we can address those challenges together and make transplantation accessible to everyone who could benefit."
