Impact of having potential living donors on ethnic/racial disparities in access

[Clark]

https://www.amjtransplant.org/article/S1600-6135(22)29946-8/fulltext

BRIEF COMMUNICATION| VOLUME 22, ISSUE 10, P2433-2442, OCTOBER 2022

Impact of having potential living donors on ethnic/racial disparities in access to kidney transplantation

      Elisa J. Gordon

Jungwha Lee
Raymond Kang
Juan Carlos Caicedo
American Journal of Transplantation
DOI:https://doi.org/10.1111/ajt.17090

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.