1
|
Alolod GP, Gardiner HM, Blunt R, Yucel RM, Siminoff LA. Organ Donation Willingness Among Asian Americans: Results from a National Study. J Racial Ethn Health Disparities 2023; 10:1478-1491. [PMID: 35595917 PMCID: PMC9675880 DOI: 10.1007/s40615-022-01333-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/05/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
Asian Americans are the fastest growing racial group in the USA, but their health disparities are often overlooked. Although their needs for transplantable organs are substantial, they have the lowest rates of organ donation per million compared to other Americans by race. To better understand Asian Americans' disposition toward organ donation, a self-administered survey was developed based on formative data collection and guidance from a Community Advisory Board composed of Asian American stakeholders. The instrument was deployed online, and quota sampling based on the 2017 American Community Survey was used to achieve a sample representative (N = 899) of the Asian American population. Bivariate tests using logistic regression and the chi-square test of independence were performed. Over half (58.1%) of respondents were willing to be organ donors. A majority (81.8%) expressed a willingness to donate a family member's organs, but enthusiasm depended on the family member's donor wishes. Only 9.5% of respondents indicated that the decision to donate their organs was theirs alone to make; the remainder would involve at least one other family member. Other key sociodemographic associations were found. This study demonstrates both the diversity of Asian Americans but also the centrality of the family's role in making decisions about organ donation. Practice and research considerations for the field are also presented.
Collapse
Affiliation(s)
- Gerard P Alolod
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Heather M Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ryan Blunt
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Recai M Yucel
- Department of Biostatistics and Epidemiology, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Laura A Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| |
Collapse
|
2
|
Gardiner HM, Davis EE, Alolod GP, Sarwer DB, Siminoff LA. A mixed-methods examination of public attitudes toward vascularized composite allograft donation and transplantation. SAGE Open Med 2022; 10:20503121221125379. [PMID: 36147872 PMCID: PMC9486253 DOI: 10.1177/20503121221125379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 08/24/2022] [Indexed: 11/29/2022] Open
Abstract
Background: This mixed-methods study examined the general public’s knowledge and
attitudes about vascularized composite allografts. The availability of these
anatomical gifts to treat individuals with severe disfiguring injuries
relies largely on decisions made by family members. If vascularized
composite allograft transplantation is to become more readily available, the
knowledge and beliefs of the general public must be explored to ensure
vascularized composite allograft donation approaches adequately support the
donation decision-making process. Methods: We conducted six focus groups with 53 members of the general public, which
were audio-recorded for accuracy and transcribed. Before each session,
participants completed a brief survey assessing donation-related knowledge,
attitudes, and beliefs. Analysis of qualitative data entailed the constant
comparison method in the development and application of a schema for
thematic coding. Descriptive statistics and Spearman’s rank coefficient were
used in the analysis of the quantitative data. Results: Respondents were most knowledgeable about solid organ donation and least
knowledgeable about vascularized composite allograft donation. Six major
themes emerged: (1) strong initial reactions toward vascularized composite
allografts, (2) limited knowledge of and reservations about vascularized
composite allografts, (3) risk versus reward in receiving a vascularized
composite allograft, (4) information needed to authorize vascularized
composite allograft donation, (5) attitudes toward donation, and (6)
mistrust of the organ donation system. Conclusion: The general public has low levels of knowledge and high levels of hesitation
about vascularized composite allograft donation and transplantation.
Education campaigns to familiarize the general public with vascularized
composite allografts and specialized training for donation professionals to
support informed family decision-making about vascularized composite
allograft donation may address these issues.
Collapse
Affiliation(s)
- Heather M Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Ellen E Davis
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Gerard P Alolod
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - David B Sarwer
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| | - Laura A Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, USA
| |
Collapse
|
3
|
Ferguson SA, Panos JJ, Sloper D, Varma V, Sarkar S. Alzheimer's disease: a step closer to understanding type 3 diabetes in African Americans. Metab Brain Dis 2021; 36:1803-1816. [PMID: 34021875 DOI: 10.1007/s11011-021-00754-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
Alzheimer's disease (AD) is the fourth leading cause of death in the United States and the most common cause of adult-onset dementia. Recent results suggest an increased prevalence and severity in African Americans compared to Caucasians. Our understanding of the potential mechanism(s) underlying this ethnicity difference is limited. We previously described ethnicity-related differences in levels of neurodegenerative proteins and cytokines/chemokines in the BA21 region of African Americans and Caucasians with AD. Here, similar multiplex assays were used to examine those endpoints in patient postmortem cerebrospinal fluid (CSF). Additionally, we measured levels of C-peptide, ghrelin, gastric inhibitory polypeptide (GIP), glucagon-like peptide-1 (GLP-1), glucagon, insulin, leptin, PAI-1, resistin, and visfatin using a human diabetes 10-plex assay. The cytokine and chemokine assays revealed that levels of 26 chemokines or cytokines differed significantly with ethnicity, and three of those were significantly associated with gender. The neurodegenerative disease panel indicated that levels of soluble RAGE were significantly elevated in African Americans compared to Caucasians. All measures in the diabetes disease panel assay were significantly elevated in African Americans: ghrelin, GIP, GLP-1, glucagon, insulin, and visfatin. Through peripheral sample analysis, these results provide further evidence that ethnicity is critically involved in the manifestation of AD.
Collapse
Affiliation(s)
- Sherry A Ferguson
- Division of Neurotoxicology, National Center for Toxicological Research/Food and Drug Administration, Jefferson, AR, 72079, USA
| | - John J Panos
- Division of Neurotoxicology, National Center for Toxicological Research/Food and Drug Administration, Jefferson, AR, 72079, USA
| | - Daniel Sloper
- Division of Systems Biology, National Center for Toxicological Research/Food and Drug Administration, Jefferson, AR, 72079, USA
| | - Vijayalakshmi Varma
- Division of Systems Biology, National Center for Toxicological Research/Food and Drug Administration, Jefferson, AR, 72079, USA
| | - Sumit Sarkar
- Division of Neurotoxicology, National Center for Toxicological Research/Food and Drug Administration, Jefferson, AR, 72079, USA.
| |
Collapse
|
4
|
Timar J, Bleil M, Daly T, Koomar S, Hasz R, Nathan H. Successful strategies to increase organ donation: the Gift of Life Donor Program Philadelphia model. Indian J Thorac Cardiovasc Surg 2021; 37:380-394. [PMID: 34629767 PMCID: PMC8464643 DOI: 10.1007/s12055-021-01219-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/19/2021] [Accepted: 05/23/2021] [Indexed: 10/20/2022] Open
Abstract
Organ donation connects the ending of one life with the renewal of another. Acute care hospitals care for the organ donor and transplant organizations complete life-saving surgeries. Between them is a vital component: a less-known medical team dedicated to ensuring that organ donation and transplantation are possible. Organ procurement organizations (OPOs) support grieving families during a painful time of loss, providing a rare and precious opportunity in donation. The OPO is simultaneously poised to ensure that organs successfully begin their journey to renewing life and restoring hope for recipients and their loved ones. Every OPO faces a myriad of challenges in meeting its responsibilities. A recognized leader in the field, Gift of Life Donor Program (GLDP) in Philadelphia, Pennsylvania has been committed to meeting these challenges for nearly fifty years. The successes of this OPO reflect the legacies of organ donors, recipients, and their cherished loved ones.
Collapse
Affiliation(s)
- Jennifer Timar
- Gift of Life Donor Program, 401 N. 3rd St, Philadelphia, PA 19123 USA
| | - Maria Bleil
- Gift of Life Donor Program, 401 N. 3rd St, Philadelphia, PA 19123 USA
| | - Theresa Daly
- Gift of Life Donor Program, 401 N. 3rd St, Philadelphia, PA 19123 USA
| | - Susan Koomar
- Gift of Life Donor Program, 401 N. 3rd St, Philadelphia, PA 19123 USA
| | - Richard Hasz
- Gift of Life Donor Program, 401 N. 3rd St, Philadelphia, PA 19123 USA
| | - Howard Nathan
- Gift of Life Donor Program, 401 N. 3rd St, Philadelphia, PA 19123 USA
| |
Collapse
|
5
|
Sieverdes JC, Mueller M, Nemeth LS, Patel S, Baliga PK, Treiber FA. A distance-based living donor kidney education program for Black wait-list candidates: A feasibility randomized trial. Clin Transplant 2021; 35:e14426. [PMID: 34269480 PMCID: PMC9888645 DOI: 10.1111/ctr.14426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 05/25/2021] [Accepted: 06/12/2021] [Indexed: 02/02/2023]
Abstract
Addressing racial disparities in living donor kidney transplants (LDKT) among Black patients warrants innovative programs to improve living donation rates. The Living Organ Video Educated Donors (LOVED) program is a 2-arm, culturally-tailored, distance-based, randomized controlled feasibility trial. The group-based, 8-week program used peer-navigator led video chat sessions and web-app video education for Black kidney waitlisted patients from United States southeastern state. Primary feasibility results for LOVED (n = 24) and usual care (n = 24) arms included LOVED program tolerability (i.e., 95.8% retention), program fidelity (i.e., 78.9% video education adherence and 72.1% video chat adherence). LDKT attitudinal and knowledge results favored the LOVED group where a statistically significant effect was reported over 6-months for willingness to approach strangers (estimate ± SE: -1.0 ± .55, F(1, 45.3) = 7.5, P = .009) and self-efficacy to advocate for a LDKT -.81 ± .31, F(1, 45.9) = 15.2, P < .001. Estimates were improved but not statistically significant for willingness to approach family and friends, LDKT knowledge and concerns for living donors (all P's > .088). Secondary measures at 6 months showed an increase in calls for LOVED compared to usual care (P = .008) though no differences were found for transplant center evaluations or LDKTs. Findings imply that LOVED increased screening calls and attitudes to approach potential donors but feasibility outcomes found program materials require modification to increase adherence.
Collapse
Affiliation(s)
- John C. Sieverdes
- College of Charleston, Department of Health and Human Performance, 24 George Street, Charleston, SC 29425-1600,Medical University of South Carolina, College of Medicine, 96 Jonathan Lucas St. Charleston, SC 29425-1600, USA
| | - Martina Mueller
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St. Charleston, SC 29425-1600, USA
| | - Lynne S. Nemeth
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St. Charleston, SC 29425-1600, USA
| | - Sachin Patel
- Medical University of South Carolina, College of Medicine, 96 Jonathan Lucas St. Charleston, SC 29425-1600, USA,Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St. Charleston, SC 29425-1600, USA
| | - Prabhakar K. Baliga
- Medical University of South Carolina, College of Medicine, 96 Jonathan Lucas St. Charleston, SC 29425-1600, USA
| | - Frank A. Treiber
- Medical University of South Carolina, College of Medicine, 96 Jonathan Lucas St. Charleston, SC 29425-1600, USA,Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St. Charleston, SC 29425-1600, USA
| |
Collapse
|
6
|
Acceptability of a Mobile-Health Living Kidney Donor Advocacy Program for Black Wait-Listed Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168239. [PMID: 34443991 PMCID: PMC8393864 DOI: 10.3390/ijerph18168239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 11/16/2022]
Abstract
Marked racial disparities exist in rates of living donor kidney transplantation (LDKT). The Living Organ Video Educated Donors (LOVED) program is a distance-based, mobile health program designed to help Black kidney transplant wait-list patients advocate for a living donor. This study reported on the acceptability outcomes to aid in future refinements. Participants were randomized to LOVED (n = 24, mean age = 50.9 SD (9.2) years), male = 50%) and usual care groups (n = 24 (mean age 47.9 SD (10.0), male 50%). Four LOVED groups completed an eight-week intervention that consisted of six online video education modules and eight group video chat sessions led by a Black navigator. Qualitative analysis from post-study focus groups resulted in six themes: (1) video chat sessions provided essential support and encouragement, (2) videos motivated and made participants more knowledgeable, (3) connectivity with tablets was acceptable in most areas, (4) material was culturally sensitive, (5) participation was overall a positive experience and (6) participants were more willing to ask for a kidney now. The video chat sessions were pertinent in participant satisfaction, though technology concerns limited program implementation. Results showed that the LOVED program was acceptable to engage minorities in health behavior changes for living donor advocacy but barriers exist that require future refinement.
Collapse
|
7
|
DuBay DA, Ivankova NV, Herbey I, Redden DT, Holt C, Siminoff L, Fouad MN, Morinelli TA, Martin MY. An African American Perspective on Familial Notification of Becoming a Registered Organ Donor. Prog Transplant 2019; 29:164-172. [PMID: 30845889 DOI: 10.1177/1526924819835837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Studies demonstrate that family notification is much less frequent in African Americans than in Caucasians. Familial notification of one's decision to become a registered organ donor (ROD) is important to ensure adherence to the decedent's donation decision and to disseminate prodonation attitudes. The purpose of this study was to explore the experiences of familial notification among recent African American RODs and to identify intervention strategies to overcome potential barriers to the notification process. METHODS/APPROACH The study used a qualitative focus group approach. An inductive thematic analysis identified common categories and themes in the recorded and transcribed discussions. FINDINGS The focus groups consisted of 50 African American participants who had recently visited Alabama Department of Motorized Vehicles and made the voluntary decision (yes or no) about becoming an organ donor. Three major themes describing the African American experiences with notifying their family members about their decision to become a ROD emerged. These themes were as follows: motivation for the notification, notification conversation, and promoting familial notification. Specific discussions centered upon the importance of and barriers to familial notification, information, and strategies needed for successful notification. Strategies identified were use of media and social networks to provide enhanced knowledge on the notification process and the importance of health-care, community-provided knowledge about the donation process. DISCUSSION Findings from this study provide a framework for future interventions designed to assist African American RODs in notifying family members of their status.
Collapse
Affiliation(s)
- Derek A DuBay
- 1 Department of Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Nataliya V Ivankova
- 2 Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA.,3 Department of Acute, Chronic and Continuing Care, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ivan Herbey
- 4 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David T Redden
- 5 Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cheryl Holt
- 6 Department of Behavioral and Community Health, School of Public Health, University of Maryland, College Park, MD, USA
| | - Laura Siminoff
- 7 College of Public Health, Temple University, Philadelphia, PA, USA
| | - Mona N Fouad
- 4 Division of Infectious Diseases, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Thomas A Morinelli
- 1 Department of Surgery, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Michelle Y Martin
- 8 Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN, USA
| |
Collapse
|
8
|
Assari S. Multiplicative Effects of Social and Psychological Risk Factors on College Students' Suicidal Behaviors. Brain Sci 2018; 8:brainsci8050091. [PMID: 29772772 PMCID: PMC5977082 DOI: 10.3390/brainsci8050091] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 05/12/2018] [Accepted: 05/14/2018] [Indexed: 11/17/2022] Open
Abstract
Less is known about the multiplicative effects of social and psychological risk and protective factors of suicidality on college campuses. The current study aimed to investigate the multiplicative effects of social (identifying oneself as gay/lesbian, financial difficulty, violence victimization, and religiosity) and psychological (anxiety, depression, problem alcohol use, drug use) and risk/protective factors on suicidal behaviors among college students in the United States. Using a cross-sectional design, the Healthy Mind Study (HMS; 2016–2017), is a national online survey of college students in the United States. Social (identifying oneself as gay/lesbian, violence victimization, financial difficulty, and religiosity) and psychological (anxiety, depression, problem alcohol use, and drug use) risk/protective factors were assessed among 27,961 individuals. Three aspects of suicidality, including ideation, plan, and attempt, were also assessed. Logistic regression models were used for data analysis. Financial difficulty, violence victimization, identifying oneself as gay/lesbian, anxiety, depression, and drug use increased, while religiosity reduced the odds of suicidal behaviors. Multiplicative effects were found between the following social and psychological risk factors: (1) financial difficulty and anxiety; (2) financial difficulty and depression; (3) depression and drug use; (4) problem alcohol use and drug use; and (5) depression and problem alcohol use. There is a considerable overlap in the social and psychological processes, such as financial stress, mood disorders, and substance use problems, on risk of suicide in college students. As social and psychological risk factors do not operate independently, comprehensive suicidal risk evaluations that simultaneously address multiple social and psychological risk factors may be superior to programs that only address a single risk factor.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| |
Collapse
|
9
|
Pauli J, Basso K, Ruffatto J. The influence of beliefs on organ donation intention. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2017. [DOI: 10.1108/ijphm-08-2016-0040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Recent technological developments in healthcare have enabled an increased number of organ transplantation surgeries. At the same time, there is an increase in the number of people awaiting organ transplant, coupled with the difficulty in donation. To bridge this gap, this study aims to propose to evaluate the effect of three types of beliefs (clinical beliefs, financial incentive beliefs and beliefs on the social benefits of altruism and solidarity) on the intention to donate organs. Moreover, this paper uses the attitudes in relation to donation to explain the effect of these beliefs on the intention to donate organs.
Design/methodology/approach
The research was conducted using a survey of 422 Brazilian participants and a mediation analysis to test the mediation hypotheses.
Findings
The results suggest that the effect of three types of beliefs (clinical, economic order and social solidarity) influence the intention to donate organs indirectly through the formation of attitudes concerning organ donation.
Research limitations/implications
This article contributes to the understanding of the formation of organ donation intentions and the role of different types of beliefs in the formation of such intentions.
Originality/value
The findings extend the discussions regarding the role of beliefs in the formation of attitudes and intentions of organ donation and have significant value in creating public policies that further promote organ donation.
Collapse
|
10
|
Melnikov S, Ashkenazi T, Amara M, Peles Bortz A. Transcendental Spirituality and Acquaintance With the Activities of the Domestic National Transplant Center as Factors Shaping Attitudes Toward Organ Donation. Prog Transplant 2017; 27:139-145. [DOI: 10.1177/1526924817699967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Context: Organ donation has been shown to be perceived as inappropriate by religiously observant individuals. The impact of spirituality level on attitudes toward organ donation has not been broadly explored. Objective: To explore the contribution of ethnicity, spirituality, level of religious observance, and acquaintance with the activities of the Israel National Transplant Center (INTC) to forming attitudes toward organ donation among Jews and Muslim Arabs in Israel. Design: A descriptive cross-sectional survey. Participants: Three hundred five (65.2%) Jewish and 163 (34.8%) Muslim Arab respondents living in Israel. Results: Jewish respondents had more positive attitudes toward organ donation than Muslim Arabs. Muslim Arabs had a higher mean spirituality score than Jews. Gender, age, ethnicity, level of religious observance, education, 4 spirituality dimensions, and acquaintance with the activities of the INTC explained 41.5% of the variance in attitudes to organ donation. Transcendental spirituality, acquaintance with the activities of the INTC, and level of religious observance had the highest contribution to explaining attitudes to organ donation, while gender and age had a low contribution. Ethnicity, education, and the 3 other spirituality dimensions were not found to have a significant contribution. Conclusion: A multifaceted approach to improving attitudes toward organ donation among Jews and Muslim Arabs in Israel is important.
Collapse
Affiliation(s)
- Semyon Melnikov
- Department of Nursing, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tamar Ashkenazi
- Israel National Transplant Center, Ministry of Health, Tel Aviv, Israel
| | - Muhammad Amara
- Imam of Israeli Arab Village of Zalafa, Zalafa, Ma’ale Iron, Israel
| | | |
Collapse
|
11
|
Rodrigue JR, Kazley AS, Mandelbrot DA, Hays R, LaPointe Rudow D, Baliga P. Living Donor Kidney Transplantation: Overcoming Disparities in Live Kidney Donation in the US--Recommendations from a Consensus Conference. Clin J Am Soc Nephrol 2015; 10:1687-95. [PMID: 25883072 DOI: 10.2215/cjn.00700115] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Despite its superior outcomes relative to chronic dialysis and deceased donor kidney transplantation, live donor kidney transplantation (LDKT) is less likely to occur in minorities, older adults, and poor patients than in those who are white, younger, and have higher household income. In addition, there is considerable geographic variability in LDKT rates. Concomitantly, in recent years, the rate of living kidney donation (LKD) has stopped increasing and is declining, after decades of consistent growth. Particularly noteworthy is the decline in LKD among black, younger, male, and lower-income adults. The Live Donor Community of Practice within the American Society of Transplantation, with financial support from 10 other organizations, held a Consensus Conference on Best Practices in Live Kidney Donation in June 2014. The purpose of this meeting was to identify LKD best practices and knowledge gaps that might influence LDKT, with a focus on patient and donor education, evaluation efficiencies, disparities, and systemic barriers to LKD. In this article, we discuss trends in LDKT/LKD and emerging novel strategies for attenuating disparities, and we offer specific recommendations for future clinical practice, education, research, and policy from the Consensus Conference Workgroup focused on disparities.
Collapse
Affiliation(s)
- James R Rodrigue
- Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Abby Swanson Kazley
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Didier A Mandelbrot
- Transplant Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin; and
| | - Rebecca Hays
- Transplant Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin; and
| | - Dianne LaPointe Rudow
- Recanati Miller Transplantation Institute, Mount Sinai Medical Center, New York, New York
| | - Prabhakar Baliga
- Department of Surgery, Medical University of South Carolina, Charleston, South Carolina;
| | | |
Collapse
|
12
|
Robinson DHZ, Arriola KRJ. Strategies to facilitate organ donation among African Americans. Clin J Am Soc Nephrol 2015; 10:177-9. [PMID: 25635039 DOI: 10.2215/cjn.12561214] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
13
|
EXP CLIN TRANSPLANTExp Clin Transplant 2014; 12. [DOI: 10.6002/ect.2014.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
|