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Concerns of ABO incompatible and crossmatch‐positive potential donors and recipients about participating in kidney exchanges
Author(s) -
Rodrigue James R.,
Leishman Ruthanne,
Vishnevsky Tanya,
Evenson Amy,
Mandelbrot Didier A.
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12509
Subject(s) - distrust , medicine , health care , family medicine , surgery , psychology , political science , law , psychotherapist
Kidney paired exchanges ( KPE s) have increased, yet are still underutilized. This study aimed to develop tools for assessing KPE concerns, identify predictors of KPE concerns, and describe common KPE concerns among potential living donors ( LD s) and intended recipients. Incompatible former potential LD s (n = 135) and intended recipients (n = 83) retrospectively completed questionnaires to assess KPE concerns. Healthcare system distrust also was assessed. A minority (n = 48 or 36.5% of potential LD s; n = 25 or 30.1% of intended recipients) had pursued KPE participation. Of those who pursued KPE participation, 11 (22.9%) and 6 (24.0%) completed KPE donation or transplantation, respectively. The questionnaires for potential LD s and recipients showed good internal consistency and preliminary convergent validity. LD s and patients less willing to pursue KPE reported more KPE concerns. Common KPE concerns for both potential LD s and recipients were related to perceived Distrust/Inequity and Inconvenience/Cost. Multivariate predictors of more KPE concerns were as follows: male gender ( t = 4.5, p < 0.001) and more healthcare system distrust ( t = 2.5, p = 0.01) for potential LD s; black race ( t = 2.1, p = 0.04) and more healthcare system distrust ( t = 2.3, p = 0.03) for intended recipients. These findings underscore the importance of addressing concerns potential LD s and patients have about KPE if the true potential of KPE is to be realized.