Abstract: TH-PO1148
Willingness to Consider Increased-Risk Public Health Service Organs Among Waitlisted African Americans
Session Information
- Transplantation: Clinical - Pretransplant Management
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Authors
- Mohottige, Dinushika, Duke University, School of Medicine, Durham, North Carolina, United States
- Ellis, Matthew Jay, Duke University Medical Center, Durham, North Carolina, United States
- Sudan, Debra, Duke University Medical Center, Durham, North Carolina, United States
- Davenport, Clemontina A., Duke University Medical Center, Durham, North Carolina, United States
- Zhang, Xiyuan, Duke University, School of Medicine, Durham, North Carolina, United States
- Strigo, Tara Smith, Duke University Medical Center, Durham, North Carolina, United States
- Ephraim, Patti, Johns Hopkins University, Baltimore, Maryland, United States
- Barrett, Tyler M., Duke University School of Medicine, Durham, North Carolina, United States
- Cabacungan, Ashley N., Division of General Internal Medicine, Durham, North Carolina, United States
- Boulware, L. Ebony, Duke University School of Medicine, Durham, North Carolina, United States
Background
It is unknown if African Americans (AAs), who have historically experienced medical mistrust and health care discrimination, are willing to accept Public Health Service increased risk (PHSIR) kidneys with increased risk of transmitting hepatitis B, C and HIV.
Methods
We conducted a cross-sectional study among AAs listed for a kidney transplant. We assessed participants’ willingness to accept PHSIR kidneys using transplant center written consent forms. In logistic regression models, we quantified the independent association of willingness with participants’ sociodemographics, attitudes including medical mistrust, concerns about medical experimentation (e.g. ‘how likely is it that you or people like you might be used in experiments without your consent’), trust in doctors (e.g. ‘I trust doctors to put my needs above all others’), and racial, gender, income, and age-based discrimination experience (e.g., ‘Do you believe you have ever received worse medical care than other patients because of your race’).
Results
Among 300 AA participants, mean (SD) age was 52 (11), 77% were dialysis dependent for a median of 3 (IQR 1,4) years, 45% were female, and 61% college educated. Most (89%) were willing to accept PHSIR kidneys. Participants’ trust in doctors was high (95%), while prior perceived racial or income-based discrimination was lower (20% and 22%). Individuals willing (vs. not) to accept PHSIR kidneys were older (mean 52 vs. 48 years), had lower prevalence of high health literacy (21% vs. 42%), poorer (18% vs. 9%), and reported more racial (16% vs. 10%) or income (19% vs. 12%) discrimination. After adjustment, those with greater than HS literacy (versus less) had lower odds of willingness (OR [95% CI] 0.36 [0.13, 0.99]). Medical mistrust measures were not associated with willingness.
Conclusion
AA potential kidney transplant recipients had high willingness to accept PHSIR kidneys, suggesting utilization of these kidneys could help to increase transplant rates among minorities.
Funding
- NIDDK Support