Abstract: TH-PO1173
Social Network Interventions to Reduce Racial/Ethnic Living Donor Kidney Transplants (LDKT) Disparities: Preliminary Results from the Friends and Family of Kidney Transplant Patients Study
Session Information
- Late-Breaking Science Posters
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Daw, Jonathan, The Pennsylvania State University, University Park, Pennsylvania, United States
- Kirk, Jennifer Marie, The Pennsylvania State University, University Park, Pennsylvania, United States
- Verdery, Ashton, The Pennsylvania State University, University Park, Pennsylvania, United States
- Ortiz, Selena E, The Pennsylvania State University, University Park, Pennsylvania, United States
- Reed, Rhiannon D., University of Alabama at Birmingham, Birmingham, Alabama, United States
- Locke, Jayme E., University of Alabama at Birmingham, Birmingham, Alabama, United States
- Kloda, David, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Mccauley, Brian Andrew, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
- Sawinski, Deirdre L., Weill Cornell Medicine, New York, New York, United States
- Reese, Peter P., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
Background
Kidney transplants are often the optimal therapy for those w/ end-stage kidney disease; LDKT are particularly beneficial. Yet, LDKT rates are low & substantial racial/ethnic disparities in LDKT are a key driver of disparities in outcomes. Hence, more research is needed to boost LDKT & reduce racial/ethnic disparities.
Methods
This 2x2 factorial clinical trial in 2 transplant centers randomized 158 transplant candidates to the following groups: 1) the Script intervention: sets of advice & an example script on how to initiate LDKT discussions w/ potential living donors; 2) the Search intervention: advice on which friends/family members were least likely to have LDKT contraindications; 3) the Combined Intervention; or 4) No Intervention controls.
Results
Gender, age, & race/ethnicity did not differ by intervention group at baseline. At a median of 11 months post-enrollment, 17% of participants remained active on the waitlist, 3.8% died, 52% became/remained waitlist inactive. Only 11% of participants received LDKT, including 15% of controls, while 27% of the Search group received a deceased donor kidney transplant. Results indicate that neither intervention significantly increased the likelihood of LDKT (See Table). Notably, Non-Hispanic (NH) Black participants remained significantly (p=.01) less likely to receive LDKT.
Conclusion
We aimed to increase LDKT & ameliorate racial/ethnic disparities through the implementation of Script & Search interventions. Findings indicate neither intervention alone nor in combination significantly influenced LDKT. These results underscore the need for further investigation into alternative strategies to increase LDKT, particularly among racial/ethnic minorities.
Multivariable Logistic Regression Analysis of Interventions & Race/Ethnicity on LDKT
| Model 1 | Model 2 | Model 3 | Final Model | |||||||||
| Variable | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p | OR | 95% CI | p |
| Script Intervention | 0.64 | 0.35, 1.07 | .11 | 0.59 | 0.32, 1.00 | .06 | 0.59 | 0.32, 1.01 | .07 | 0.59 | 0.32, 1.00 | .06 |
| Search Intervention | 1.01 | 0.61, 1.67 | >.9 | 0.92 | 0.54, 1.56 | .8 | 0.94 | 0.52, 1.65 | .8 | 0.92 | 0.54, 1.56 | .8 |
| Race/Ethnicity | ||||||||||||
| NH White | — | — | — | — | — | — | ||||||
| NH Black | 0.14 | 0.02, 0.53 | .01 | 0.13 | 0.02, 0.53 | .01 | 0.14 | 0.02, 0.53 | .01 | |||
| Other | 0.43 | 0.06, 1.73 | .3 | 0.42 | 0.06, 1.72 | .3 | 0.43 | 0.06, 1.73 | .3 | |||
| Combined Intervention | 1.06 | 0.58, 1.86 | .9 | |||||||||
Funding
- NIDDK Support