Context Given the shortage of kidneys available for transplantation, a community-based intervention trial was implemented to assess the impact of an educational program on patients' access to live donor kidney transplantation (LDKT). Objective To compare the short-term impact of a basic intervention and an enhanced intervention on patients' readiness to pursue LDKT. Design Baseline data and data from 1 week after interventions were analyzed. Participants 214 transplant-eligible hemodialysis patients attending 14 dialysis facilities in Maryland, Virginia, and Pennsylvania. Interventions In the basic intervention, 107 patients watched a 10-minute videotape on the experience of recipients and live donors of a kidney. In the enhanced intervention, 107 patients watched the same videotape and had a discussion with a health educator on the risks and benefits of LDKT, who could be a donor, and how to address the barriers they were encountering when seeking a live kidney donor. Main outcome measure Patient reported whether they were considering LDKT, had talked with family or friends about LDKT, and had asked someone for a kidney. Results Over half of transplant-eligible patients were not pursuing LDKT at baseline (64% in the basic intervention group, 61% in the enhanced intervention group). One week after the intervention, the odds of considering LDKT were higher among African Americans (odds ratio [OR], 2.28; confidence interval [CI], 1.22–4.25), younger patients (OR, 0.94; CI, 0.91–0.97), and patients who spent less time on dialysis (OR, 0.90; CI, 0.83–0.97). The odds of asking for a kidney were higher among African Americans (OR, 4.94; CI, 2.54–9.60) and patients who perceived they were in poor to fair health (OR, 3.30; CI, 1.12–9.67). Conclusions Although both interventions helped patients consider LDKT and ask for a kidney, more time and expanded educational content might be needed to facilitate patients' discussion about LDKT with their loved ones.
Association of Race and Ethnicity With Live Donor Kidney Transplantation in the United States From 1995 to 2014
