Weng Francis L, Davis LaShara A, Ohman-Strickland Pamela A, Waterman Amy D
Renal and Pancreas Transplant Division, Saint Barnabas Medical Center, Livingston, NJ.
Rutgers University School of Public Health, Piscataway, NJ.
Transplant Direct. 2021 Mar 16;7(4):e683. doi: 10.1097/TXD.0000000000001136. eCollection 2021 Apr.
For most patients with kidney failure, living donor kidney transplant (LDKT) is their best treatment option. Compared with White people, Black people are more likely to have kidney failure but less likely to receive LDKTs. In this study, the investigators will test an educational intervention, Destination Transplant, designed to reduce this disparity, among Black people already listed for kidney transplant.
The investigators will conduct a parallel group, 2-arm randomized clinical trial among 500 Black kidney transplant candidates. The main objective of this study is to test an educational and behavioral intervention that is designed to increase receipt of LDKT among transplant candidates (persons active on the deceased donor kidney transplant waiting list) who are Black. Candidates on the kidney transplant waiting list will be randomly assigned to 1 of 2 conditions: (1) a control group that will receive Usual Care, or (2) an Intervention group that will receive Destination Transplant, a 9-month intervention that includes an in-person group-based education session, postcards at monthly intervals, and a follow-up phone call from a transplant educator. At baseline and during 18 months of follow-up, demographic and clinical variables will be collected, as well as variables such as transplant derailers (factors that might be sources of delay, difficulty, or challenge to pursuing transplant), transplant knowledge, and health literacy, small steps taken to pursue LDKT, readiness for LDKT, decisional balance and self-efficacy LDKT, decisional conflict, family support, availability of potential living donors, and general health status.
This educational intervention aims to increase both readiness to pursue LDKT and actual receipt of LDKTs among Black and African American patients who are already on the kidney transplant waiting list. The aim of the intervention is to reduce racial disparities in access to LDKT.
对于大多数肾衰竭患者来说,活体供肾移植(LDKT)是他们最佳的治疗选择。与白人相比,黑人患肾衰竭的可能性更高,但接受活体供肾移植的可能性更低。在这项研究中,研究人员将对已列入肾移植名单的黑人进行一项教育干预措施“移植目的地”测试,旨在减少这种差异。
研究人员将在500名黑人肾移植候选者中进行一项平行组、双臂随机临床试验。本研究的主要目的是测试一种教育和行为干预措施,该措施旨在增加已列入肾移植名单(在尸体供肾移植等待名单上活跃的人)的黑人移植候选者接受活体供肾移植的比例。肾移植等待名单上的候选者将被随机分配到以下两种情况之一:(1)接受常规护理的对照组;(2)接受“移植目的地”干预组,这是一项为期9个月的干预措施,包括一次面对面的小组教育课程、每月一次的明信片以及来自移植教育者的随访电话。在基线期和18个月的随访期间,将收集人口统计学和临床变量,以及移植阻碍因素(可能是追求移植过程中的延迟、困难或挑战来源的因素)、移植知识、健康素养、为追求活体供肾移植所采取的小步骤、对活体供肾移植的准备情况、决策平衡和活体供肾移植自我效能、决策冲突、家庭支持、潜在活体供体的可用性以及总体健康状况等变量。
这种教育干预旨在提高已在肾移植等待名单上的黑人和非裔美国患者追求活体供肾移植的意愿以及实际接受活体供肾移植的比例。该干预的目的是减少在获取活体供肾移植方面的种族差异。