Barriers to Living Donor Kidney Transplantation in Black Patients with Kidney Disease

Document Type

Conference Proceeding

Publication Date

8-2-2025

Publication Title

Am J Transplant

Abstract

Purpose: Lower rates of Living donor kidney transplantation (LDKT) among Black patients are attributed to socioeconomic and cultural factors. We report results of a cross-sectional survey undertaken to assess attitudes towards LDKT in patients with kidney disease. Methods: Patients with ESRD and CKD from local dialysis centers and nephrology clinic were invited to complete a survey. The17-question survey was adapted from published measures of LDKT knowledge, attitudes and concerns. The BHLS (Brief health literacy screening) tool was included .We examined potential differences in attitudes towards LKD in Black vs white patients using T-tests and Fisher exact tests, The primary analysis assessed differences in attitudes towards LKD in Black vs white patients. The secondary analysis assessed differences based on gender, health literacy, median household income, dialysis status (on dialysis vs pre-emptive), and location of the dialysis center with respect to historic residential segregation. A sub-analysis was conducted in Black patients to examine the impact of low health literacy, and income. Results: 88 patients completed the survey. 62 patients identified as Black, 23 White, 3 Hispanic. Baseline characteristics are summarized in Table 1. Black patients had significantly lower median household income than white patients. Black patients were less likely to tell a potential donor how to contact the living donor(LD) program (29% vs 56%, p=0.02).Greater number of patients from dialysis units in areas of historic residential segregation reported that no-one in their family or friends’ group know about LKD (47.8% vs 35.8%, p=0.04) and were fearful that they might lose KT (47.8% vs 33.3%, p=0.01).Patients with a low BHLS score (0-6) were less likely to tell their potential donors how to contact the LD team, as compared to patients with a BHLS score >6 (17% vs 46%, p=0.009). There was a trend towards significance in greater number of patients with inadequate health literacy feeling that out-of-pocket expenses for living donors are too high (76% vs 54%, p=0.06). On sub analysis of only black patients with inadequate vs marginal/adequate literacy, this trend became significant (82% vs 51% p=0.016). Conclusions: Limited health literacy and residential segregation play an important role in shaping black patients’ attitudes with regards to receiving a LDKT. Each demographic area is unique with regards to interaction between socioeconomic and cultural factors as they relate to LDKT, and educational resources should be made available with a more targeted focus to address limited health literacy in patients with kidney disease [Formula presented] CITATION INFORMATION: Prashar R., Patel A. Barriers to Living Donor Kidney Transplantation in Black Patients with Kidney Disease AJT, Volume 25, Issue 8 Supplement 1 DISCLOSURES: R. Prashar: None.

Volume

25

Issue

8

First Page

S907

Last Page

S908

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