TY - JOUR
T1 - Ethnic background is associated with no live kidney donor identified at the time of first transplant assessment—an opportunity missed? A single-center retrospective cohort study
AU - Vedadi, Ali
AU - Bansal, Aarushi
AU - Yung, Priscilla
AU - Famure, Olusegun
AU - Mitchell, Margot
AU - Waterman, Amy D.
AU - Singh, Sunita K.
AU - Novak, Marta
AU - Kim, Sang Joseph
AU - Mucsi, Istvan
N1 - Publisher Copyright:
© 2019 Steunstichting ESOT
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Patients from ethnocultural minorities have reduced access to live donor kidney transplant (LDKT). To explore early pretransplant ethnocultural disparities in LDKT readiness, and the impact of the interactions with the transplant program, we assessed if patients had a potential live donor (LD) identified at first pretransplant assessment, and if patients with no LD initially received LDKT subsequently. Single-center, retrospective cohort of adults referred for kidney transplant (KT) assessment. Multivariable logistic regression assessed the association between ethnicity and having a potential LD. Cox proportional hazard analysis assessed the association between no potential LD initially and subsequent LDKT. Of 1617 participants, 66% of Caucasians indicated having a potential LD, compared with 55% of South Asians, 44% of African Canadians, and 41% of East Asians (P < 0.001). In multivariable logistic regression analysis, the odds of having a potential LD identified was significantly lower for African, East and South Asian Canadians. No potential LD at initial KT assessment was associated with lower likelihood of LDKT subsequently (hazard ratio [HR], 0.14; [0.10–0.19]). Compared to Caucasians, African, East and South Asian and African Canadians are less likely to have a potential LD identified at first KT assessment, which predicts a lower likelihood of subsequent LDKT.
AB - Patients from ethnocultural minorities have reduced access to live donor kidney transplant (LDKT). To explore early pretransplant ethnocultural disparities in LDKT readiness, and the impact of the interactions with the transplant program, we assessed if patients had a potential live donor (LD) identified at first pretransplant assessment, and if patients with no LD initially received LDKT subsequently. Single-center, retrospective cohort of adults referred for kidney transplant (KT) assessment. Multivariable logistic regression assessed the association between ethnicity and having a potential LD. Cox proportional hazard analysis assessed the association between no potential LD initially and subsequent LDKT. Of 1617 participants, 66% of Caucasians indicated having a potential LD, compared with 55% of South Asians, 44% of African Canadians, and 41% of East Asians (P < 0.001). In multivariable logistic regression analysis, the odds of having a potential LD identified was significantly lower for African, East and South Asian Canadians. No potential LD at initial KT assessment was associated with lower likelihood of LDKT subsequently (hazard ratio [HR], 0.14; [0.10–0.19]). Compared to Caucasians, African, East and South Asian and African Canadians are less likely to have a potential LD identified at first KT assessment, which predicts a lower likelihood of subsequent LDKT.
KW - African Canadian
KW - Asian Canadian
KW - equitable access
KW - ethnocultural disparity
KW - kidney transplant
KW - live donor kidney transplant
KW - transplant education
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U2 - 10.1111/tri.13476
DO - 10.1111/tri.13476
M3 - Article
C2 - 31250484
AN - SCOPUS:85068900163
SN - 0934-0874
VL - 32
SP - 1030
EP - 1043
JO - Transplant International
JF - Transplant International
IS - 10
ER -