Hispanic/Latino Disparities in Living Donor Kidney Transplantation

Gordon, Elisa J.; Lee, Jung Hwa; Kang, Raymond; Ladner, Daniela P.; Skaro, Anton I.; Holl, Jane L.; French, Dustin D.; Abécassis, Michaël; Caicedo, Juan C.

doi:10.1097/txd.0000000000000540

Cited by 49 publications

(54 citation statements)

References 27 publications

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“…47,50 The HKTP provides 2 sequential group educational sessions in Spanish by a Hispanic transplant surgeon (J.C.C.) as the first phase of kidney transplant evaluation for potential kidney recipients and live donors, 1 to 2 times per month.…”

Section: Northwestern Memorial Hospitalmentioning

confidence: 99%

A Culturally Targeted Website for Hispanics/Latinos About Living Kidney Donation and Transplantation

Gordon¹,

Feinglass

Carney

et al. 2016

Transplantation

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Section: Northwestern Memorial Hospitalmentioning

confidence: 99%

A Culturally Targeted Website for Hispanics/Latinos About Living Kidney Donation and Transplantation

Gordon¹,

Feinglass

Carney

et al. 2016

Transplantation

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“…11,12 The HKTP involves numerous culturally targeted components: community engagement; bilingual and bicultural staff; communication in Spanish; and transplant education for patients, their families, and potential donors that addresses Hispanic cultural values and beliefs. Although the HKTP has been described at length elsewhere, additional details are provided below.…”

Section: Settingmentioning

confidence: 99%

“…Although the HKTP has been described at length elsewhere, additional details are provided below. 11,12 The HKTP involves numerous culturally targeted components: community engagement; bilingual and bicultural staff; communication in Spanish; and transplant education for patients, their families, and potential donors that addresses Hispanic cultural values and beliefs. 12 Community engagement entails a bilingual, bicultural outreach staff (social worker or nurse) speaking directly to Hispanic dialysis patients in Spanish (or English) about the HKTP at dialysis centers.…”

Section: Settingmentioning

confidence: 99%

“…5 To date, several interventions have been shown to effectively increase LDKTs, 6,7 but few have been culturally targeted to redress disparities in LDKT access. 11 Little is known about patients' perceptions of the HKTP and its culturally targeted components. Since its inception in 2006, the HKTP has been associated with increased LDKT rates and reduced LDKT disparities among Hispanics patients.…”

mentioning

confidence: 99%

“…Since its inception in 2006, the HKTP has been associated with increased LDKT rates and reduced LDKT disparities among Hispanics patients. 11 Little is known about patients' perceptions of the HKTP and its culturally targeted components. A survey study of HKTP participants found that the culturally competent aspects of care were "a lot" or "completely" important to them.…”

mentioning

confidence: 99%

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Patients' perceptions of a culturally targeted Hispanic Kidney Transplant Program: A mixed methods study

Alhalel

Francone

Salazar

et al. 2019

Clinical Transplantation

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Disproportionately fewer waitlisted Hispanics receive living donor kidney transplants (LDKTs) compared to non‐Hispanic whites. Northwestern Medicine's® culturally targeted Hispanic Kidney Transplant Program (HKTP) is associated with a significant increase in LDKTs among Hispanics. This multisite study assessed potential kidney recipients' and donors' and/or family members' perceptions of the HKTP's cultural components through semi‐structured interviews and validated surveys. Qualitative thematic analysis and descriptive statistics were performed. Thirty‐six individuals participated (62% participation rate) comprising 21 potential recipients and 15 potential donors/family (mean age: 51 years, 50% female, 72% preferred Spanish). Participants felt confident about the educational information because a transplant physician delivered the education and viewed the group format as effective. Participants felt that education sessions addressed myths about transplantation shared by Hispanics. Primary use of Spanish enhanced participants' understanding of transplantation. While few knew about living donation before attending the HKTP, most were “more in favor of” kidney transplantation (97%) and living donation (97%) afterward. Few reported learning about the HKTP from outreach staff and suggested leveraging community leaders to promote HKTP awareness. Our findings suggest the HKTP's cultural components were viewed favorably and positively influenced perceptions of kidney transplantation and living donation, which may help reduce transplant disparities in Hispanics. (Clinicaltrial.gov registration # NCT03276390, date of registration: 9‐7‐17, retrospectively registered).

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Neighborhood Segregation and Access to Live Donor Kidney Transplantation

Li,

Menon,

Kim

et al. 2024

JAMA Intern Med

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ImportanceIdentifying the mechanisms of structural racism, such as racial and ethnic segregation, is a crucial first step in addressing the persistent disparities in access to live donor kidney transplantation (LDKT).ObjectiveTo assess whether segregation at the candidate’s residential neighborhood and transplant center neighborhood is associated with access to LDKT.Design, Setting, and ParticipantsIn this cohort study spanning January 1995 to December 2021, participants included non-Hispanic Black or White adult candidates for first-time LDKT reported in the US national transplant registry. The median (IQR) follow-up time for each participant was 1.9 (0.6-3.0) years.Main Outcome and MeasuresSegregation, measured using the Theil H method to calculate segregation tertiles in zip code tabulation areas based on the American Community Survey 5-year estimates, reflects the heterogeneity in neighborhood racial and ethnic composition. To quantify the likelihood of LDKT by neighborhood segregation, cause-specific hazard models were adjusted for individual-level and neighborhood-level factors and included an interaction between segregation tertiles and race.ResultsAmong 162 587 candidates for kidney transplant, the mean (SD) age was 51.6 (13.2) years, 65 141 (40.1%) were female, 80 023 (49.2%) were Black, and 82 564 (50.8%) were White. Among Black candidates, living in a high-segregation neighborhood was associated with 10% (adjusted hazard ratio [AHR], 0.90 [95% CI, 0.84-0.97]) lower access to LDKT relative to residence in low-segregation neighborhoods; no such association was observed among White candidates (P for interaction = .01). Both Black candidates (AHR, 0.94 [95% CI, 0.89-1.00]) and White candidates (AHR, 0.92 [95% CI, 0.88-0.97]) listed at transplant centers in high-segregation neighborhoods had lower access to LDKT relative to their counterparts listed at centers in low-segregation neighborhoods (P for interaction = .64). Within high-segregation transplant center neighborhoods, candidates listed at predominantly minority neighborhoods had 17% lower access to LDKT relative to candidates listed at predominantly White neighborhoods (AHR, 0.83 [95% CI, 0.75-0.92]). Black candidates residing in or listed at transplant centers in predominantly minority neighborhoods had significantly lower likelihood of LDKT relative to White candidates residing in or listed at transplant centers located in predominantly White neighborhoods (65% and 64%, respectively).ConclusionsSegregated residential and transplant center neighborhoods likely serve as a mechanism of structural racism, contributing to persistent racial disparities in access to LDKT. To promote equitable access, studies should assess targeted interventions (eg, community outreach clinics) to improve support for potential candidates and donors and ultimately mitigate the effects of segregation.

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Hispanic/Latino Disparities in Living Donor Kidney Transplantation

Cited by 49 publications

References 27 publications

A Culturally Targeted Website for Hispanics/Latinos About Living Kidney Donation and Transplantation

A Culturally Targeted Website for Hispanics/Latinos About Living Kidney Donation and Transplantation

Patients' perceptions of a culturally targeted Hispanic Kidney Transplant Program: A mixed methods study

Neighborhood Segregation and Access to Live Donor Kidney Transplantation

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