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Gordon EJ, Lee J, Kang R, Caicedo JC. Impact of having potential living donors on ethnic/racial disparities in access to kidney transplantation. Am J Transplant 2022; 22:2433-2442. [PMID: 35524363 PMCID: PMC9547969 DOI: 10.1111/ajt.17090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/10/2022] [Accepted: 05/03/2022] [Indexed: 01/25/2023]
Abstract
Racial/ethnic disparities persist in patients' access to living donor kidney transplantation (LDKT). This study assessed the impact of having available potential living donors (PLDs) on candidates' receipt of a kidney transplant (KT) and LDKT at two KT programs. Using data from our clinical trial of waitlisted candidates (January 1, 2014-December 31, 2019), we evaluated Hispanic and Non-Hispanic White (NHW) KT candidates' number of PLDs. Multivariable logistic regression assessed the impact of PLDs on transplantation (KT vs. no KT; for KT recipients, LDKT vs. deceased donor KT). A total of 847 candidates were included, identifying as Hispanic (45.8%) or NHW (54.2%). For Site A, both Hispanic (adjusted OR = 2.26 [95% CI 1.13-4.53]) and NHW (OR = 2.42 [1.10-5.33]) candidates with PLDs completing the questionnaire were more likely to receive a KT. For Site B, candidates with PLDs were not significantly more likely to receive KT. Among KT recipients at both sites, Hispanic (Site A: OR = 21.22 [2.44-184.88]; Site B: OR = 25.54 [7.52-101.54]), and NHW (Site A: OR = 37.70 [6.59-215.67]; Site B: OR = 15.18 [5.64-40.85]) recipients with PLD(s) were significantly more likely to receive a LDKT. Our findings suggest that PLDs increased candidates' likelihood of KT receipt, particularly LDKT. Transplant programs should help candidates identify PLDs early in transplant evaluation.
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Affiliation(s)
- Elisa J. Gordon
- Department of Surgery‐ Division of TransplantationCenter for Health Services and Outcomes ResearchCenter for Bioethics and Medical HumanitiesNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Jungwha Lee
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Raymond Kang
- Center for Community HealthNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Juan Carlos Caicedo
- Department of Surgery‐ Division of TransplantationNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
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Gordon EJ, Uriarte J, Lee J, Kang R, Shumate M, Ruiz R, Mathur AK, Ladner DP, Caicedo JC. Effectiveness of a culturally competent care intervention in reducing disparities in Hispanic live donor kidney transplantation: A hybrid trial. Am J Transplant 2022; 22:474-488. [PMID: 34559944 PMCID: PMC8813886 DOI: 10.1111/ajt.16857] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/30/2021] [Accepted: 09/15/2021] [Indexed: 02/03/2023]
Abstract
Hispanic patients receive disproportionately fewer living donor kidney transplants (LDKTs) than non-Hispanic Whites (NHWs). The Northwestern Medicine Hispanic Kidney Transplant Program (HKTP), designed to increase Hispanic LDKTs, was evaluated as a nonrandomized, implementation-effectiveness hybrid trial of patients initiating transplant evaluation at two intervention and two similar control sites. Using a mixed method, observational design, we evaluated the fidelity of the HKTP implementation at the two intervention sites. We tested the impact of the HKTP intervention by evaluating the likelihood of receiving LDKT comparing pre-intervention (January 2011-December 2016) and postintervention (January 2017-March 2020), across ethnicity and centers. The HKTP study included 2063 recipients. Intervention Site A exhibited greater implementation fidelity than intervention Site B. For Hispanic recipients at Site A, the likelihood of receiving LDKTs was significantly higher at postintervention compared with pre-intervention (odds ratio [OR] = 3.17 95% confidence interval [1.04, 9.63]), but not at the paired control Site C (OR = 1.02 [0.61, 1.71]). For Hispanic recipients at Site B, the likelihood of receiving an LDKT did not differ between pre- and postintervention (OR = 0.88 [0.40, 1.94]). The LDKT rate was significantly lower for Hispanics at paired control Site D (OR = 0.45 [0.28, 0.90]). The intervention significantly improved LDKT rates for Hispanic patients at the intervention site that implemented the intervention with greater fidelity. Registration: ClinicalTrials.gov registered (retrospectively) on September 7, 2017 (NCT03276390).
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Affiliation(s)
- Elisa J. Gordon
- Department of Surgery- Division of Transplantation, Center for Health Services and Outcomes Research, Center for Bioethics and Medical Humanities, Northwestern University Feinberg School of Medicine
| | - Jefferson Uriarte
- Center for Health Services and Outcomes Research, Northwestern University Feinberg School of Medicine
| | - Jungwha Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine
| | - Raymong Kang
- Center for Community Health, Northwestern University Feinberg School of Medicine
| | - Michelle Shumate
- Delaney Family University Research Professor, Department of Communication Studies, Northwestern University
| | - Richard Ruiz
- Department of Surgery, Baylor University Medical Center
| | | | - Daniela P. Ladner
- Department of Surgery-Division of Transplantation, Northwestern University Feinberg School of Medicine
| | - Juan Carlos Caicedo
- Department of Surgery-Division of Transplantation, Northwestern University Feinberg School of Medicine
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Factors Associated with the Willingness to Become a Living Kidney Donor: A National Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031313. [PMID: 35162337 PMCID: PMC8835691 DOI: 10.3390/ijerph19031313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 02/05/2023]
Abstract
Introduction: Living donor kidney transplantation is the preferred method of treating kidney failure. The donor agrees to undergo an elective procedure for the benefit of the recipient. Aim: To assess the attitude toward living kidney donation and to investigate the factors that contribute to kidney donation willingness. Methods: A cross-sectional study was carried out between December 2020 and February 2021. The study covered a representative group of 953 Poles aged 18−77, living in all Polish voivodships. The relationship between sociodemographic factors, personal values (Personal Values List), the total score of life satisfaction (Satisfaction with Life Scale) and the willingness to donate a kidney to another human was assessed using a logistic regression model. Results: The most frequently chosen personal values were: good health; physical and mental fitness; love and friendship; knowledge and wisdom. The most frequently chosen symbols of happiness were: good health, successful family life, being needed by others. The median satisfaction with life for the entire group was 20 [16; 24]. Voluntary donation of a kidney to another human being i.e., family, friends, strangers were more often declared by women (OR = 1.21; Cl95%: 1.03−1.42), for whom the most important symbol of happiness was a life full of adventures, travels (OR = 1.39; Cl95%: 1.06−1.82) and the most important personal value was goodness and tenderness (OR = 1.21; Cl95%: 1.05−1.40). Total scores of The Satisfaction with Life Scale correlated positively with the willingness to voluntarily donate a kidney (OR = 1.03; Cl95%: 1.003−1.06), while age correlated negatively (OR = 0.99; Cl95%: 0.98−0.99). Conclusions: Respondents who declare their willingness to be a living kidney donor are mainly female, for which the most important symbol of happiness is a life full of adventures and travel, and the most important values are personal goodness and tenderness. The desire to donate a kidney to another person decreases with age and grows with life satisfaction. Trial registration: ClinicalTrials.gov (ID: NCT04789122).
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Sharaan R, Alsulami S, Arab R, Alzeair G, Elamin N, Alsaywid B, Lytras M. Knowledge, Attitude, and Willingness Toward Kidney Donation Among Health Sciences Students at King Saud Bin Abdulaziz University. Front Public Health 2021; 9:667582. [PMID: 34164369 PMCID: PMC8215665 DOI: 10.3389/fpubh.2021.667582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 04/13/2021] [Indexed: 11/29/2022] Open
Abstract
Background: End-stage renal disease, as one of the most serious and major health problems, does not have many treatment options available. One of the best treatment modalities used to cure this debilitating disease is kidney transplantation. However, with the continuous increase in number of patients diagnosed with it, there is not enough supply of the organ. The aim of our study is to assess knowledge about, attitude toward, and willingness to donate kidney among health science students at King Saud bin Abdulaziz University in comparison to the general population in Jeddah and to investigate the factors that play a role on their willingness. Methods: This is an observational, analytical, cross-sectional study design conducted in 2019. Two target populations were included: King Saud bin Abdulaziz University for Health Sciences students and the general population in Jeddah. Data were collected via a self-administered, close-ended, structured, and previously validated questionnaire that contained 39 items divided into four sections. SPSS program version 22 was used in data analysis. Results: Out of 685 surveyed participants, 179 (26.1%) were willing to donate their kidney, with students showing a higher rate of willingness (N = 101; 32.3%) than the general population (N = 78; 21%). However, only 46 (6.7%) out of the total population hold an organ donor card. In bivariate analysis, it was found that knowledge significantly associated with a higher rate of willingness among the student population than the general population, while positive beliefs were associated with increased willingness in the general population than students. Positive attitude appeared to play a role in higher willingness among the general population and student population. Conclusion: There is a low perception of awareness regarding kidney donation in both populations of this study. The willingness rate of health science students at King Saud bin Abdulaziz University and the general population was low when compared with other studies conducted internationally.
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Affiliation(s)
- Raghad Sharaan
- King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, Saudi Arabia
| | - Sara Alsulami
- King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, Saudi Arabia
| | - Raneem Arab
- King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, Saudi Arabia
| | - Ghida Alzeair
- King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, Saudi Arabia
| | - Nadia Elamin
- King Saud Bin Abdulaziz University for Health Sciences, College of Medicine, Jeddah, Saudi Arabia
| | - Basim Alsaywid
- Urology Section, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard, Jeddah, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard, Jeddah, Saudi Arabia.,Planning and Organizational Excellence Administration, Saudi Commission for Health Specialties, Riyadh, Saudi Arabia
| | - Miltiadis Lytras
- Effat College of Engineering, Effat University, Jeddah, Saudi Arabia.,Distinguished Scientists Program, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
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Luo AJ, Xu ZH, Cai PP, He HY, Mao P, Xie WZ. Qualitative Study on the Influencing Factors and Countermeasures Against Job Burnout Among Organ Donation Coordinators. Front Public Health 2020; 8:571514. [PMID: 33194972 PMCID: PMC7641619 DOI: 10.3389/fpubh.2020.571514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 09/01/2020] [Indexed: 11/17/2022] Open
Abstract
Background: Most organ donation coordinators suffer varying degrees of anxiety, depression and poor sleep caused by constant work pressure, and their professional identity is only at a medium level. All of this leads to a great risk of job burnout. Objective: To identify the influencing factors of and effective countermeasures against job burnout among organ donation coordinators. Method: Semistructured interviews were used for data collection. In-person or phone interviews were conducted from December 2017 to June 2018. Results: 12 organ donation coordinators who came from 7 different provinces and cities in China were interviewed. The interview data were sorted, and relevant topics were extracted and summarized in terms of two aspects, namely, factors that influenced job burnout in organ donation coordinators and effective countermeasures for dealing with job burnout. Conclusion: Factors influencing job burnout among organ donation coordinators include personal factors, job responsibilities, salary and benefit factors, and donor family factors. Measures to help organ donation coordinators effectively address burnout include self-regulation, social support, and positive events.
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Affiliation(s)
- Ai-Jing Luo
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,School of Life Sciences, Central South University, Changsha, China.,Public Health College of Central South University, Changsha, China
| | - Ze-Hua Xu
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,Public Health College of Central South University, Changsha, China
| | - Ping-Ping Cai
- Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hai-Yan He
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China.,School of Life Sciences, Central South University, Changsha, China
| | - Ping Mao
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China
| | - Wen-Zhao Xie
- The Third Xiangya Hospital of Central South University, Changsha, China.,Key Laboratory of Medical Information Research (Central South University), College of Hunan Province, Changsha, China
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