Open Access

Federica Bocchi, Selina Müller, Isabelle Binet, Dela Golshayan, Fadi Haidar, Thomas Müller, Stefan Schaub, Aurelia Schnyder, Daniel Sidler, Federico Storni, Patrizia Amico, Adrian Bachofner, Vanessa Banz, Sonja Beckmann, Guido Beldi, Christoph Berger, Ekaterine Berishvili, Annalisa Berzigotti, Pierre-Yves Bochud, Sanda Branca, Heiner Bucher, Anne Cairoli, Emmanuelle Catana, Yves Chalandon, Sabina De Geest, Sophie De Seigneux, Michael Dickenmann, Joëlle Lynn Dreifuss, Michel Duchosal, Thomas Fehr, Sylvie Ferrari-Lacraz, Jaromil Frossard, Christian Garzoni, Déla Golshayan, Nicolas Goossens, Fadi Haidar, Jörg Halter, Dominik Heim, Christoph Hess, Sven Hillinger, Hans Hirsch, Patricia Hirt, Linard Hoessly, Günther Hofbauer, Uyen Huynh-Do, Franz Immer, Michael Koller, Andreas Kremer, Thorsten Krueger, Christian Kuhn, Bettina Laesser, Frédéric Lamoth, Roger Lehmann, Alexander Leichtle, Oriol Manuel, Hans-Peter Marti, Michele Martinelli, Valérie McLin, Katell Mellac, Aurélia Merçay, Karin Mettler, Nicolas Müller, Ulrike Müller-Arndt, Beat Müllhaupt, Mirjam Nägeli, Graziano Oldani, Manuel Pascual, Jakob Passweg, Rosemarie Pazeller, Klara Posfay-Barbe, David Reineke, Juliane Rick, Anne Rosselet, Simona Rossi, Rössler, Silvia Rothlin, Frank Ruschitzka, Thomas Schachtner, Stefan Schaub, Alexandra Scherrer, Dominik Schneidawind, Aurelia Schnyder, Macé Schuurmans, Simon Schwab, Thierry Sengstag, Federico Simonetta, Jürg Steiger, Guido Stirniman, Ueli Stürzinger, Christian Van Delden, Jean-Pierre Venetz, Jean Villard, Julien Vionnet, Madeleine Wick, Markus Wilhlem, Patrick Yerly

• Introduction Most of Switzerland’s population and employment opportunities are concentrated in urban areas. Although kidney transplantation (KT) is the preferred therapy for eligible candidates, individuals in rural areas face challenges accessing specialized medical services due to longer travel distances. Limited understanding exists regarding patients' perspectives on returning to work after KT and whether this correlates with their urbanization status, potentially influencing outcomes. Methods Retrospective, nationwide (Swiss Transplant Cohort Study [STCS]) study, from May 2008 to 2020, including 1926 patients aged 18 to 60 years who underwent KT. We investigated the self-reported work reintegration at 1, 3, and 5 years after the KT, the recipient and allograft survival, and the allograft function at 12 months, contingent on urbanization status (urban, suburban, rural). Results The return rate of sufficiently filled-in questionnaires was 81% (1053 participants). UrbanIntroduction Most of Switzerland’s population and employment opportunities are concentrated in urban areas. Although kidney transplantation (KT) is the preferred therapy for eligible candidates, individuals in rural areas face challenges accessing specialized medical services due to longer travel distances. Limited understanding exists regarding patients' perspectives on returning to work after KT and whether this correlates with their urbanization status, potentially influencing outcomes. Methods Retrospective, nationwide (Swiss Transplant Cohort Study [STCS]) study, from May 2008 to 2020, including 1926 patients aged 18 to 60 years who underwent KT. We investigated the self-reported work reintegration at 1, 3, and 5 years after the KT, the recipient and allograft survival, and the allograft function at 12 months, contingent on urbanization status (urban, suburban, rural). Results The return rate of sufficiently filled-in questionnaires was 81% (1053 participants). Urban recipients were younger, had longer dialysis time before KT, and had less living donor KT. At baseline, the level of education, as well as the workforce defined as work capacity > 50%, were lower in urban areas (37% urban, 39% suburban, and 47% rural). Regression analysis revealed significantly higher odds ratio for employment 1 year post-KT among patients residing in rural and suburban areas (odds ratio: 1.31 [confidence interval: 1.04–1.65] and 1.52 [confidence interval: 1.16–1.98], respectively) compared to patients from urban regions. Stratified according to urbanization environment, recipient and allograft survival were comparable across groups. Conclusion Patient and graft outcomes were favorable, with improved work reintegration observed at the 1-year mark post-KT for recipients from rural backgrounds compared to those from suburban and urban areas.…