Skip to main content

Advertisement

Log in

Overcoming Disparities in Living Donor Kidney Transplantation in the USA: the Promise of Academic and Community Stakeholder Partnerships

  • Live Kidney Donation (K Lentine and R Schaffer, Section Editors)
  • Published:
Current Transplantation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Living donor kidney transplantation (LDKT) has been shown to be the optimal treatment for clinically suitable patients with end-stage renal disease (ESRD). Despite the benefits, racial/ethnic and socioeconomic disparities persist in receipt of LDKT. These disparities may be mitigated through the development of academic and community-based partnerships.

Recent Findings

This article provides a systematic review of existing academic-community partnerships designed to address disparities in LDKT for adult populations in the USA. Few academic-community partnerships exist that were designed to specifically address LDKT disparities. Among the 7 existing partnerships identified within this review, the majority were developed as part of grant-funded interventions targeting healthcare access, health education, and health attitudes and behaviors as barriers to LDKT.

Summary

Future work is needed to identify practical methods for expanding LDKT partnerships among health equity researchers, healthcare practitioners, transplant centers, and other key stakeholders, including patients, families, faith-based leaders, policy makers, and medically underserved communities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Renal Data System US. 2018 USRDS annual data report: epidemiology of kidney disease in the United States. Bethesda, MD: National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases; 2018.

    Google Scholar 

  2. Scientific Registry of Transplant Recipients. 2016 SRTR annual data report. https://srtr.transplant .hrsa.gov/annual_reports/Default.aspx. Last accessed 4 Jan 2019.

  3. • Purnell TS, Luo X, Cooper LA, Massie AB, Kucirka LM, Henderson ML, et al. Association of race and ethnicity with live donor kidney transplantation in the United States from 1995 to 2014. JAMA. 2018;319(1):49–61 This study demonstrated that disparities in the receipt of live donor kidney transplantation in the USA worsened from 1995–1999 to 2010–2014.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Rodrigue JR, Schold JD, Mandelbrot DA. The decline in living kidney donation in the United States: random variation or cause for concern? Transplantation. 2013;96(9):767–73.

    Article  PubMed  Google Scholar 

  5. Johansen KL, Zhang R, Huang Y, Patzer RE, Kutner NG. Association of race and insurance type with delayed assessment for kidney transplantation among patients initiating dialysis in the United States. Clin J Am Soc Nephrol. 2012;7(9):1490–7.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Waterman AD, Rodrigue JR, Purnell TS, Ladin K, Boulware LE. Addressing racial and ethnic disparities in live donor kidney transplantation: priorities for research and intervention. Semin Nephrol. 2010;30(1):90–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Hall EC, James NT, Garonzik-Wang JM, et al. Center-level factors and racial disparities in living donor kidney transplantation. Am J Kidney Dis. 2012;59(6):849–57.

    Article  PubMed  Google Scholar 

  8. Purnell TS, Hall YN, Boulware LE. Understanding and overcoming barriers to living kidney donation among racial and ethnic minorities in the United States. Adv Chronic Kidney Dis. 2012;19(4):244–51.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Purnell TS, Xu P, Leca N, Hall YN. Racial differences in determinants of live donor kidney transplantation in the United States. Am J Transplant. 2013;13(6):1557–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Boulware LE, Meoni LA, Fink NE, et al. Preferences, knowledge, communication and patient-physician discussion of living kidney transplantation in African American families. Am J Transplant. 2005;5(6):1503–12.

    Article  PubMed  Google Scholar 

  11. Rodrigue JR, Kazley AS, Mandelbrot DA, Hays R, LaPointe RD. Baliga P; American Society of Transplantation. Living donor kidney transplantation: overcoming disparities in live kidney donation in the US—recommendations from a consensus conference. Clin J Am Soc Nephrol. 2015;10(9):1687–95.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Waterman AD, Robbins ML, Peipert JD. Educating prospective kidney transplant recipients and living donors about living donation: practical and theoretical recommendations for increasing living donation rates. Curr Transplant Rep. 2016;3(1):1–9 Epub 2016 Jan 26.

    Article  PubMed  PubMed Central  Google Scholar 

  13. • Lentine KL, Mandelbrot D. Addressing Disparities in Living Donor Kidney Transplantation: A Call to Action. Clin J Am Soc Nephrol. 2018;13(12):1909–11 This study provides a call to action for robust national efforts from researchers, educators, nephrology providers, and policy makers urgently needed to support opportunities for healthy, willing persons to become living donors, regardless of race and socioeconomic status.

    Article  PubMed  Google Scholar 

  14. •• Purnell TS, Calhoun EA, Golden SH, Halladay JR, Krok-Schoen JL, Appelhans BM, et al. Achieving health equity: closing the gaps in health care disparities, interventions, and research. Health Aff (Millwood). 2016;35(8):1410–5 Authors discuss gaps in knowledge and translation in many existing health equity interventions and highlight innovative strategies that will help to address these gaps to advance health equity.

    Article  Google Scholar 

  15. •• O'Mara-Eves A, Brunton G, McDaid D, Oliver S, Kavanagh J, Jamal F, et al. Community engagement to reduce inequalities in health: a systematic review, meta-analysis and economic analysis. Southampton (UK): NIHR Journals Library. 2013 This study reviews relevant theories of change and introduces a new conceptual framework as useful tools for researchers and practitioners designing community engagement interventions.

  16. Patzer RE, Gander J, Sauls L, Amamoo MA, Krisher J, Mulloy LL, et al. The RaDIANT community study protocol: community-based participatory research for reducing disparities in access to kidney transplantation. BMC Nephrol. 2014;15:171.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Patzer RE, Paul S, Plantinga L, Gander J, Sauls L, Krisher J, et al. A randomized trial to reduce disparities in referral for transplant evaluation. J Am Soc Nephrol. 2017;28(3):935–42.

    Article  PubMed  Google Scholar 

  18. Gordon EJ, Lee J, Kang R, Ladner DP, Skaro AI, Holl JL, et al. Hispanic/Latino disparities in living donor kidney transplantation: role of a culturally competent transplant program. Transplant Direct. 2015;1(8):e29.

    Article  Google Scholar 

  19. Gordon EJ, Feinglass J, Carney P, Vera K, Olivero M, Black A, et al. A website intervention to increase knowledge about living kidney donation and transplantation among Hispanic/Latino dialysis patients. Prog Transplant. 2016;26(1):82–91.

    Article  PubMed  Google Scholar 

  20. Gordon EJ, Lee J, Kang RH, Caicedo JC, Holl JL, Ladner DP, et al. A complex culturally targeted intervention to reduce Hispanic disparities in living kidney donor transplantation: an effectiveness-implementation hybrid study protocol. BMC Health Serv Res. 2018;18(1):368.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Green JA, Ephraim PL, Hill-Briggs FF, Browne T, Strigo TS, Hauer CL, et al. Putting patients at the center of kidney care transitions: PREPARE NOW, a cluster randomized controlled trial. Contemp Clin Trials. 2018;73:98–110.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Locke JE, Qu H, Shewchuk R, Mannon RB, Gaston R, Segev DL, et al. Identification of strategies to facilitate organ donation among African Americans using the nominal group technique. Clin J Am Soc Nephrol. 2015;10(2):286–93.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Jacob Arriola KR, Redmond N, Williamson DHZ, Thompson NJ, Perryman JP, Patzer RE, Williams M. A community-based study of giving acts: organ donation education for African American adults. J Natl Med Assoc. 2018. pii: S0027–9684(18)30235–9. https://doi.org/10.1016/j.jnma.2018.09.005. [Epub ahead of print].

  24. Rodrique JR, et al. Comparing the effectiveness of house calls and peer mentorship to reduce racial disparities in live donor kidney transplantation. https://www.pcori.org/research-results/2017/comparing-approaches-improve-black-patients’-chances-getting-live-donor-kidney. Published September 19, 2018. Last accessed 15 Jan 2019.

  25. Waterman AD, McSorley AM, Peipert JD, Goalby CJ, Peace LJ, Lutz PA, et al. Explore transplant at home: a randomized control trial of an educational intervention to increase transplant knowledge for Black and White socioeconomically disadvantaged dialysis patients. BMC Nephrol. 2015;16:150.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Waterman AD, Peipert JD. An explore transplant group randomized controlled education trial to increase dialysis patients' decision-making and pursuit of transplantation. Prog Transplant. 2018;28(2):174–83.

    Article  PubMed  Google Scholar 

  27. National Minority Organ Tissue Transplant Education Program: Celebrating 25 Years of Saving Lives. https://www.natlmottep.org/. Last accessed 14 Feb 2019.

Download references

Funding

This work was supported in part by grant K01HS024600 (PI: Purnell) from the Agency for Healthcare Research and Quality. The funders had no role in the design and conduct of the study, interpretation of the data, or preparation of the manuscript.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tanjala S. Purnell.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Live Kidney Donation

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Johnson, M., Lacy, N., Wilson, J. et al. Overcoming Disparities in Living Donor Kidney Transplantation in the USA: the Promise of Academic and Community Stakeholder Partnerships. Curr Transpl Rep 6, 184–191 (2019). https://doi.org/10.1007/s40472-019-00244-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40472-019-00244-3

Keywords

Navigation