Member's paper - Kidney Health Education and Research Group

Abstract

South Asian and Muslim Canadian Patients are less likely to receive Living Donor Kidney Transplant (LDKT) offers compared to Caucasian, Non-Muslim Patients

Abeera Ali1, Ali Ayub1, Candice Richardson1, Nathaniel Edwards1, Tibyan Ahmed1, Marta Novak2, Istvan Mucsi1

2018

American Transplant Congress

Full Abstract
Background: No studies have assessed whether Muslim Canadians face barriers to accessing LDKT. We explored how frequently Muslim or South Asian patients with and stage kidney disease (ESKD) receive LDKT offers and if they had a potential living donor (LD) identified. Methods: We used a cross-sectional, convenience sample of adult patients with ESKD from several hospitals in Toronto, Ontario. Non-English speaking patients and patients unwilling to consent were excluded. Based on self-identified religious affiliation and ethnicity patients were grouped as: 1) Muslims 2) Caucasian, Non-Muslims 3) South Asian, Non-Muslims 4) Non-Caucasian, Non-Muslims. Patients were asked whether anyone had offered to be a living donor for them and if they had a LD identified (outcome variables). Logistic regression was used to analyze the association between religion/ethnicity and outcome variables. Results: Out of 367 participants 5%(18) were Muslim, 40%(134) Caucasian, non-Muslim and 13%(44) South Asian, non-Muslim. The mean (SD) age was 58(13) years, 60%(221) were male. Muslim patients tended to be younger in comparison to Caucasian, non-Muslims (53[14] versus 58[14] years, p=0.074). Compared to Caucasian, Non-Muslims, Muslim patients tended to be less likely to report receiving an offer for living donation (OR=0.47, CI: 0.17-1.30, P=0.147), although the association was significant only after adjusting for age, gender, and education (OR=0.32, CI: 0.11-0.96, P=0.043). South Asian, Non-Muslims, in comparison to Caucasian, Non-Muslims, also seemed to be less likely to report receiving an offer for living donation after adjusting for age, gender, and education (OR=0.48, CI: 0.23-1.01, P=0.052). Qualitatively similar results were seen for ?having a potential living donor identified? in both groups. Conclusion: Muslim and South Asian patients with ESKD are less likely to receive a living kidney donation offer compared to Caucasian, Non-Muslims. These patients are, therefore, less likely to receive a LDKT. An unclear understanding of the Islamic perspective on organ donation and additional cultural or religious factors may contribute to the observed inequity.

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