Readiness of wait-listed black patients to pursue live donor kidney transplant

Context-For adults with end-stage kidney disease, live donor kidney transplant (LDKT) has better outcomes than long-term dialysis and deceased donor kidney transplant. However, black patients receive LDKT at a much lower rate than adults of any other race or ethnicity. Objective-To examine the LDKT readiness stage of black patients on the transplant waiting list and its association with LDKT knowledge, concerns, and willingness. Design-Cross-sectional analysis of baseline data from a randomized controlled trial to improve knowledge and reduce concerns about LDKT. Patients and Setting-One hundred fifty-two black patients on the kidney transplant waiting list at a single transplant center in the northeastern United States. Main Outcome Measures-LDKT readiness stage, knowledge, concerns, and willingness to talk to others about living donation. Results-Sixty percent of patients were not considering or not yet ready to pursue LDKT, and only 11% had taken action to talk to family members or friends about the possibility of living kidney donation. Patients in later stages of LDKT readiness (ie, who had talked to others about donation or were preparing to do so) had significantly more knowledge (P< .001), fewer concerns (P= .002), and more willingness (P= .001) to talk to others about living donation than those in earlier readiness stages. Conclusions-The large percentage of black patients who are in the earlier stages of LDKT readiness may account for the low rate of LDKT in this patient population at our transplant center. Innovative and tailored LDKT educational strategies for black patients are needed to help reduce racial disparities in LDKT. (C) 2014 NATCO, The Organization for Transplant Professionals