Predictors of Having a Potential Live Donor: A Prospective Cohort Study of Kidney Transplant Candidates

• Published in: American journal of transplantation Vol. 9; no. 12; pp. 2792 - 2799
• Main Authors: Reese, P. P., Shea, J. A., Bloom, R. D., Berns, J. S., Grossman, R., Joffe, M., Huverserian, A., Feldman, H. I.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01.12.2009; Wiley
• Subjects: Adult; Aged; Biological and medical sciences; Cohort Studies; Female; Health disparities; Health Knowledge, Attitudes, Practice; Humans; Kidney Failure, Chronic - surgery; Kidney Transplantation; live donor; Living Donors - psychology; Living Donors - statistics & numerical data; Male; Medical sciences; Middle Aged; Miscellaneous; Patient Selection; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Self Efficacy; Social Support; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Surveys and Questionnaires; Tissue and Organ Procurement - methods; Living donor; Prediction; Homotransplantation; Kidney; live donor; Prospective; Treatment; Urinary system; Surgery; Cohort study; Graft; Predictive factor; Public health; Inequality; Kidney transplantation; Health disparities
• DOI: 10.1111/j.1600-6143.2009.02848.x
• ISSN: 1600-6135

The barriers to live donor transplantation are poorly understood. We performed a prospective cohort study of individuals undergoing renal transplant evaluation. Participants completed a questionnaire that assessed clinical characteristics as well as knowledge and beliefs about transplantation. A participant satisfied the primary outcome if anyone contacted the transplant center to be considered as a live donor for that participant. The final cohort comprised 203 transplant candidates, among whom 80 (39.4%) had a potential donor contact the center and 19 (9.4%) underwent live donor transplantation. In multivariable logistic regression, younger candidates (OR 1.65 per 10 fewer years, p < 0.01) and those with annual income ≥US$ 15 000 (OR 4.22, p = 0.03) were more likely to attract a potential live donor. Greater self‐efficacy, a measure of the participant's belief in his or her ability to attract a donor, was a predictor of having a potential live donor contact the center (OR 2.73 per point, p < 0.01), while knowledge was not (p = 0.56). The lack of association between knowledge and having a potential donor suggests that more intensive education of transplant candidates will not increase live donor transplantation. On the other hand, self‐efficacy may be an important target in designing interventions to help candidates find live donors. This prospective cohort study of kidney transplant candidates at a single center revealed that low income and older age were associated with a lower odds of attracting a potential live donor, while knowledge about transplantation, gender and race were not associated with the outcome.