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Racial differences in completion of the living kidney donor evaluation process
Author(s) -
Kumar Komal,
Tonascia James M.,
Muzaale Abimereki D.,
Purnell Tanjala S.,
Ottmann Shane E.,
Al Ammary Fawaz,
Bowring Mary G.,
Poon Anna,
King Elizabeth A.,
Massie Allan B.,
Chow Eric K. H.,
Thomas Alvin G.,
Ying Hao,
Borja Marvin,
Konel Jonathan M.,
Henderson Macey,
Cameron Andrew M.,
GaronzikWang Jacqueline M.,
Segev Dorry L.
Publication year - 2018
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.13291
Subject(s) - medicine , referral , donation , kidney transplantation , transplantation , african american , gerontology , family medicine , ethnology , economics , history , economic growth
Racial disparities in living donor kidney transplantation (LDKT) persist but the most effective target to eliminate these disparities remains unknown. One potential target could be delays during completion of the live donor evaluation process. We studied racial differences in progression through the evaluation process for 247 African American (AA) and 664 non‐AA living donor candidates at our center between January 2011 and March 2015. AA candidates were more likely to be obese (38% vs 22%: P < .001), biologically related (66% vs 44%: P < .001), and live ≤50 miles from the center (64% vs 37%: P < .001) than non‐AAs. Even after adjusting for these differences, AAs were less likely to progress from referral to donation (aHR for AA vs non‐AA: 0.26 0.47 0.83; P = .01). We then assessed racial differences in completion of each step of the evaluation process and found disparities in progression from medical screening to in‐person evaluation (aHR: 0.41 0.62 0.94; P = .02) and from clearance to donation (aHR: 0.28 0.51 0.91; P = .02), compared with from referral to medical screening (aHR: 0.78 1.02 1.33; P = .95) and from in‐person evaluation to clearance (aHR: 0.59 0.93 1.44; P = .54). Delays may be a manifestation of the transplant candidate's social network, thus, targeted efforts to optimize networks for identification of donor candidates may help address LDKT disparities.