Abstract: SA-PO088
Does Financial Assistance for Travel and Subsistence Costs Alleviate Racial/Ethnic Disparities in Living Kidney Donation? An Analysis of NLDAC and SRTR Data
Session Information
- Transplantation: Recipient and Donor Assessment
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1802 Transplantation: Clinical
Authors
- Mathur, Amit K., Mayo Clinic , Phoenix, Arizona, United States
- Xing, Jiawei, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
- Warren, Patricia H., American Society of Transplant Surgeons, Arlington, Virginia, United States
- Gifford, Kimberly Ann, American Society of Transplant Surgeons (ASTS), Arlington, Virginia, United States
- Hong, Barry A., Washington University School of Medicine, St Louis, Missouri, United States
- Ojo, Akinlolu O., University of Arizona Health Sciences, Tucson, Arizona, United States
- Merion, Robert, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
Group or Team Name
- National Living Donor Assistance Center
Background
The National Living Donor Assistance Center (NLDAC) enables living donor kidney transplants (LKDT) through means-tested financial assistance of living kidney donors (LKD). Since LKDT occurs at lower rates in minority populations, we aimed to determine whether NLDAC utilization is associated with minority donor and recipient characteristics.
Methods
We retrospectively matched LKD data from NLDAC to Scientific Registry of Transplant Recipients (SRTR) data (2012-2015). We compared sociodemographic factors between NLDAC-using and non-NLDAC-using donors. Generalized linear mixed models with center-level random effects were used to estimate the impact of demographics on donor NLDAC use.
Results
There were 16,822 LKDT from 2012-2015. Matching to SRTR was successful for 86% of 1,419 NLDAC LKDT. Compared to non-NLDAC LKD, NLDAC LKD had a higher proportion of females (67% vs 62%), black race (15% vs 11%), Latino ethnicity (20% vs 14%), and were less educated (less than bachelors vs bachelors or more, 48% vs 45%).. NLDAC LKDT recipients were more often black (17% vs 13%), Latino (20% vs 14%), and less educated (all p<0.05). On multivariable analysis, NLDAC utilization was associated with LKD characteristics included LKD black race (OR 1.46, p=0.008), Latino ethnicity (OR 1.32, p=0.029), and female sex (OR 1.23, p=0.001); and LKDT recipient characteristics of black race (OR 1.38, p=0.017), Latino ethnicity (OR 1.29, p=0.047), and lower education (OR 1.17, p=0.012).
Conclusion
Living donor and recipient racial and ethnic minority status, as well as recipient educational status, were associated with higher NLDAC utilization among LKDT in the US. These data suggest that financial assistance programs for living donors alleviate disparities in access to LKDT.
Funding
- Other U.S. Government Support