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Title: Attitudes of African Canadian Patients with End Stage Kidney Disease Toward Living Donor Kidney Transplantation.
Authors: Vardaan Gupta1, Candice Richardson1, Dmitri Belenko1, Navneet Singh1, Allen Xu1, Punithan Thiagalingam 1, Dorothy Wong1, Heather Ford2, Marta Novak1, Istvan Mucsi1
Year: 2018
Conference: American Transplant Congress
Full Abstract* Background: African Canadian patients with end stage kidney disease (ESKD) are less likely to receive a living donor kidney transplant (LDKT) compared to Caucasian Canadians. We assess the attitudes of African Canadian patients to accepting a potential living donor (LD) offer and their willingness to take specific steps towards pursuing LDKT. Methods: In a cross-sectional, convenience sample of adult patients with ESKD from several hospitals in Toronto, Ontario, participants were asked: 1) if they had a potential LD identified; 2) if they had received a LD offer; 3) if they would accept a LD offer 4) if they took or planned to take various steps towards pursuing LDKT. Non-English-speaking patients and patients unwilling to consent were excluded. Self-reported ethnicity and socio-demographic characteristics were tabulated. Multivariable (age, sex, marital status) adjusted logistic and multionomial regression was used to assess the association between ethnicity and outcome variables. Results: Data from 367 participants was analyzed. The mean (SD) age was 58(13) years, and 221 (60%) of participants were male, 141 (38%) were Caucasian, 117 (32%) African Canadian and 109 (30%) Asian Canadian or other. One hundred and sixty-four (44%) reported having received a LD offer and 37%137 (37%) reported having a potential LD identified. African Canadians were less likely to both having received an offer (odds ratio [OR] 0.37, 95%CI 0.20-0.67) and a LD identified (OR 0.38, 95%CI 0.22-0.68). When asked if they would accept a LD offer, African Canadians were more likely to say that they were planning to accept it (relative risk ratio [RRR] 2.02, 95%CI 1.12-3.63) compared to Caucasians. However, they were more likely only to plan (as opposed to have done it already) (RRR 3.92, 95%CI 1.88-8.17) or not to plan at all (RRR 2.15, 95%CI 1.10-4.22) to talk to others about their need for a LDKT. Similar results were seen for asking potential donors directly, allowing others to ask on their behalf or sharing educational materials with potential donors. Conclusion: African Canadian patients with ESKD are less likely to have a potential living donor identified. They seem to be more willing to accept a potential LD offer compared to Caucasian patients but more hesitant to engage in important actions that are associated with increased chance of obtaining a LDKT.
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