||Vardaan Gupta1, Candice Richardson1, Dmitri Belenko1, Navneet Singh1, Allen Xu1, Punithan Thiagalingam 1, Dorothy Wong1, Heather Ford2, Marta Novak1, Istvan Mucsi1
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.
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.
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.
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.