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Transplant social worker and donor financial assistance to increase living donor kidney transplants among African Americans: The TALKS Study, a randomized comparative effectiveness trial
Author(s) -
Boulware L. Ebony,
Sudan Debra L.,
Strigo Tara S.,
Ephraim Patti L.,
Davenport Clemontina A.,
Pendergast Jane F.,
Pounds Iris,
Riley Jennie A.,
Falkovic Margaret,
Alkon Aviel,
HillBriggs Felicia,
Cabacungan Ashley N.,
Barrett Tyler M.,
Mohottige Dinushika,
McElroy Lisa,
Diamantidis Clarissa J.,
Ellis Matthew J.
Publication year - 2021
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.16403
Subject(s) - medicine , randomized controlled trial , kidney transplantation , live donor , kidney transplant , gerontology , transplantation , african american , intensive care medicine , family medicine , surgery , ethnology , history
Lack of donors hinders living donor kidney transplantation (LDKT) for African Americans. We studied the effectiveness of a transplant social worker intervention (TALK SWI) alone or paired with living donor financial assistance to activate African Americans’ potential living kidney donors. African Americans ( N = 300) on the transplant waiting list were randomly assigned to usual care; TALK SWI; or TALK SWI plus Living Donor Financial Assistance. We quantified differences in live kidney donor activation (composite rate of live donor inquiries, completed new live donor evaluations, or live kidney donation) after 12 months. Participants’ mean age was 52 years, 56% were male, and 43% had annual household income less than $40,000. Most previously pursued LDKT. Participants were highly satisfied with TALK social workers, but they rarely utilized Financial Assistance. After 12 months, few ( n = 39, 13%) participants had a new donor activation event (35 [12%] new donor inquiries; 17 [6%] new donor evaluations; 4 [1%] LDKT). There were no group differences in donor activation events (subdistribution hazard ratio [95% CI]: 1.09 [0.51–2.30] for TALK SWI and 0.92 [0.42–2.02] for TALK SWI plus Financial Assistance compared to Usual Care, p = 91). Alternative interventions to increase LDKT for African Americans on the waiting list may be needed. Trial registration: ClinicalTrials.gov (NCT02369354).