Rodrigue James R, Paek Matthew J, Egbuna Ogo, Waterman Amy D, Schold Jesse D, Pavlakis Martha, Mandelbrot Didier A
Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
University of California at Los Angeles.
Prog Transplant. 2014 Dec;24(4):355-61. doi: 10.7182/pit2014337.
For adults with end-stage kidney disease, live donor kidney transplant (LDKT) has better outcomes than long-term dialysis and deceased donor kidney transplant. However, black patients receive LDKT at a much lower rate than adults of any other race or ethnicity.
To examine the LDKT readiness stage of black patients on the transplant waiting list and its association with LDKT knowledge, concerns, and willingness.
Cross-sectional analysis of baseline data from a randomized controlled trial to improve knowledge and reduce concerns about LDKT.Patients and Setting-One hundred fifty-two black patients on the kidney transplant waiting list at a single transplant center in the northeastern United States.
LDKT readiness stage, knowledge, concerns, and willingness to talk to others about living donation.
Sixty percent of patients were not considering or not yet ready to pursue LDKT, and only 11% had taken action to talk to family members or friends about the possibility of living kidney donation. Patients in later stages of LDKT readiness (ie, who had talked to others about donation or were preparing to do so) had significantly more knowledge (P<.001), fewer concerns (P=.002), and more willingness (P=.001) to talk to others about living donation than those in earlier readiness stages.
The large percentage of black patients who are in the earlier stages of LDKT readiness may account for the low rate of LDKT in this patient population at our transplant center. Innovative and tailored LDKT educational strategies for black patients are needed to help reduce racial disparities in LDKT.
对于终末期肾病成人患者，活体供肾移植（LDKT）的效果优于长期透析和尸体供肾移植。然而，黑人患者接受LDKT的比例远低于其他任何种族或族裔的成年人。
研究移植等待名单上黑人患者的LDKT准备阶段及其与LDKT知识、担忧和意愿的关联。
对一项旨在提高知识并减少对LDKT担忧的随机对照试验的基线数据进行横断面分析。患者和研究地点——美国东北部一个移植中心的152名等待肾移植的黑人患者。
LDKT准备阶段、知识、担忧以及与他人谈论活体捐赠的意愿。
60%的患者未考虑或尚未准备好接受LDKT，只有11%的患者已采取行动与家人或朋友谈论活体肾捐赠的可能性。处于LDKT准备后期阶段（即已与他人谈论捐赠或正准备这样做）的患者比处于准备早期阶段的患者在与他人谈论活体捐赠方面有显著更多的知识（P<0.001）、更少的担忧（P = 0.002）和更强的意愿（P = 0.001）。
处于LDKT准备早期阶段的黑人患者比例较高，这可能是我们移植中心该患者群体中LDKT比例较低的原因。需要为黑人患者制定创新且量身定制的LDKT教育策略，以帮助减少LDKT中的种族差异。
