Kidney Transplant Donor
Conditions
Brief summary
While many people offer to be evaluated at transplant centers as potential living donors to donate one kidney to someone they know, few ultimately donate. Racial/ethnic minorities are less likely to become living donors. This study examines potentially modifiable factors affecting living donation in a large cohort of potential living donors from different transplant centers who are White, Black, Hispanic, and Asian. Investigators are examining ways to intervene with potential living donors to help overcome racial disparities and increase the number of people who ultimately donate.
Detailed description
The donor data collected for use in this protocol was completed from 2014 to 2018 at an outside institution. 2332 donor volunteers were evaluated at that time and all data was deidentified and brought by the principal investigator to HMRI for secondary data analysis. Five study aims were highlighted in the research strategy. The first three aims in the original research strategy/protocol WILL NOT be included in this study because this study covers the secondary data analysis ONLY. The emphasis of this study are the last two aims (#4 and #5 of the original research strategy/protocol).
Interventions
OTHERNot applicable- observational study
Potential living donors who presented for evaluation at 5 transplant centers were invited to participate in an exploratory study assessing their motivations for donating, their living donation knowledge, their financial barriers to donating, and their educational preparedness. All potential living donors completed Survey 1, and a subset of individuals who completed living donor evaluation, completed Survey 2. After 12 months, chart review for all individuals who completed Survey 1 occurred to determine whether they received a transplant or not, and if not what reasons they were ruled out. No data collection took place at Houston Methodist.
Sponsors
The Methodist Hospital Research Institute
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Live kidney donor volunteer
Exclusion criteria
* Limited proficiency in both English and Spanish * Required assistance to fill out the study questionnaire * Non-directed donors (altruistic donors who lack a specific intended recipient) * Failure to complete baseline questionnaire
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| How Changeable Factors Affect Completion of Living Donor Evaluation for Black, Hispanic, and White Volunteers | From onset of evaluation to the outcomes at 12 months | Metrics of interest include whether donor volunteers present for evaluation, defined as attending the first in-person visit, and whether they complete the donor evaluation, defined as finishing all required steps except donation. Both outcomes are measured as yes or no. Investigators will use logistic regression to examine differences in the likelihood of presentation and completion among Black, Hispanic, and White donors. Initial analyses will examine the relationship between race and each outcome separately. Race will then be included in multivariable models, with survey-based factors added by category. Changes in the size or significance of race effects after adjustment will be evaluated. If the association between race and evaluation outcomes is reduced after accounting for specific modifiable factors, these factors may represent potential targets for future interventions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| How Changeable Factors Influence Whether Living Donors Go on to Donate, Including Through Paired Exchange | From the onset of evaluation until the date of first documented live kidney donation, assessed up to 18 months | Investigators will compare the odds of donating a kidney directly or through paired exchange among Black, Hispanic, and White donor volunteers using logistic regression models. Model fit will be assessed as previously described. As in the primary measure, the bivariate relationship between donor race and each outcome will first be examined using simple logistic regression. Race will then be forced into successive models, with survey variables entered simultaneously by category. Investigators will track whether the magnitude (odds ratio) or significance of the race effect changes as additional factors are included. |
Outcome results
None listed