Effect of race and ethnicity on renal transplant referral

Suliman, Sarah T.; Carlson, Jeremy; Smotherman, Carmen; Gautam, Shiva; Heilig, Charles W.; Munroe, Charisa; Bridges, Ledetra; Ilic, Ljubomir M.

doi:10.5414/cn109858

Cited by 8 publications

(3 citation statements)

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“…Generally, scholars point to the controversy over brain death (Youngner et al 2002), bodily conceptions , and lack of information (Rady et al 2012) as central factors hindering organ donation. Researchers have also identified that these barriers are more evident in specific social groups such as racial and ethnic minorities (Johal et al 2018;Li et al 2019;Suliman et al 2019) and are also impacted by socioeconomic status (Shah et al 2018). These sociological features pose a challenge to policy-makers to encourage less inclined populations to donate organs.…”

Section: Social Solidarity and Organ Donationmentioning

confidence: 99%

Ethical Challenges of Organ Transplantation

2021

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Section: Social Solidarity and Organ Donationmentioning

confidence: 99%

Ethical Challenges of Organ Transplantation

2021

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“…2 While the incidence of ESRD from DM is 1.5-fold higher in Hispanics than in non-Hispanic whites, Hispanics often have delayed access to kidney transplants and SPKT compared to whites. [15][16][17][18][19] This is due to multiple reasons, including lack of private insurance, residing in a lowincome area, lower education, cultural beliefs, and unemployment. 19 Despite delayed access to transplants, the proportion of Hispanics receiving SPKT has increased from 7% to 15% over time.…”

Section: Introductionmentioning

confidence: 99%

Favorable outcomes in Hispanic recipients receiving simultaneous pancreas kidney transplantation

Budhiraja

Reddy

Heilman

et al. 2023

Clinical Transplantation

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The objective of this study was to compare the long‐term outcomes of Hispanic versus white recipients who underwent simultaneous pancreas kidney transplantation (SPKT). This single‐center study, conducted from 2003 to 2022, had a median follow‐up of 7.5 years. The study included 91 Hispanic and 202 white SPKT recipients. The mean age (44 vs. 46 years), percentage of males (67% vs. 58%), and body mass index (BMI) (25.6 vs. 25.3 kg/m2) were similar between the Hispanic and white groups. The Hispanic group had more recipients with type 2 diabetes (38%) compared to the white group (5%, p < .001). The duration of dialysis was longer in Hispanics (640 vs. 473 days, p = .02), and fewer patients received preemptive transplants (10% vs. 29%, p < .01) compared to whites. Hospital length of stay, rates of BK Viremia, and acute rejection episodes within 1 year were similar between the groups. The estimated 5‐year kidney, pancreas, and patient survival rates were also similar between the groups, 94%, 81%, and 95% in Hispanics, compared to 90%, 79%, and 90% in whites. Increasing age and longer duration of dialysis were risk factors for death. Although Hispanic recipients had a longer duration on dialysis and fewer preemptive transplants, the survival rates were similar to those of white recipients. However, referring providers and many transplant centers continue to overlook pancreas transplants for appropriately selected patients with type 2 diabetes, particularly among minority populations. As a transplant community, it is crucial that we make efforts to comprehend and tackle these obstacles to transplantation.

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“…These patients experience delays in receiving specialized kidney care and are 39% less likely than non-Hispanic whites to receive at least 12 months of pre-dialysis nephrology care [2]. Despite established kidney care, Hispanic patients are still less likely to be referred for transplantation compared to non-Hispanic white and Black patients [3]. Once initiated on dialysis treatment, Hispanic patients with kidney failure also experience a longer delay in becoming active on the waitlist [4].…”

Section: Introductionmentioning

confidence: 99%

Reducing disparities in kidney transplantation for Spanish-speaking patients through creation of a dedicated center

et al. 2022

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Introduction Hispanic Americans receive disproportionately fewer organ transplants than non-Hispanic whites. In 2018, the Hispanic Kidney Transplant Program (HKTP) was established as at the University of Colorado Hospital (UCH). The purpose of this quality improvement study was to examine the effect of this culturally sensitive program in reducing disparities in kidney transplantation. Methods We performed a mixed-methods analysis of data from 436 Spanish-speaking patients referred for transplant to UCH between 2015 and 2020. We compared outcomes for patients referred between 2015–2017 (n = 156) to those referred between 2018–2020 (n = 280). Semi-structured phone interviews were conducted with 6 patients per time period and with 6 nephrology providers in the Denver Metro Area. Patients and providers were asked to evaluate communication, transplant education, and overall experience. Results When comparing the two time periods, there was a significant increase in the percentage of patients being referred (79.5% increase, p-0.008) and evaluated for transplant (82.4% increase, p = 0.02) during 2018–2020. While the number of committee reviews and number waitlisted increased during 2018–2020, it did not reach statistical significance (82.9% increase, p = 0.37 and 79.5% increase, p = 0.75, respectively. During patient and provider interviews, we identified 4 themes reflecting participation in the HKTP: improved communication, enhanced patient education, improved experience and areas for advancement. Overall, patients and providers reported a positive experience with the HKTP and noted improved patient understanding of the transplantation process. Conclusions The establishment of the HKTP is associated with a significant increase in Spanish-speaking Hispanic patients being referred and evaluated for kidney transplantation.

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Effect of race and ethnicity on renal transplant referral

Cited by 8 publications

References 0 publications

Ethical Challenges of Organ Transplantation

Ethical Challenges of Organ Transplantation

Favorable outcomes in Hispanic recipients receiving simultaneous pancreas kidney transplantation

Reducing disparities in kidney transplantation for Spanish-speaking patients through creation of a dedicated center

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