Gillespie Avrum, Daw Jonathan, Brown Riley, Cappiello Jamie, Lee Briana Eugene, Fink Edward L, Gardiner Heather M, Reese Peter P, Gadegbeku Crystal A, Obradovic Zoran
Division of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Department of Sociology and Demography, College of Liberal Arts, Penn State, Philadelphia, Pennsylvania.
Kidney Med. 2023 Apr 15;5(6):100640. doi: 10.1016/j.xkme.2023.100640. eCollection 2023 Jun.
RATIONALE & OBJECTIVE: Most living kidney donors are members of a hemodialysis patient's social network. Network members are divided into core members, those strongly connected to the patient and other members; and peripheral members, those weakly connected to the patient and other members. We identify how many hemodialysis patients' network members offered to become kidney donors, whether these offers were from core or peripheral network members, and whose offers the patients accepted.
A cross-sectional interviewer-administered hemodialysis patient social network survey.
SETTING & PARTICIPANTS: Prevalent hemodialysis patients in 2 facilities.
Network size and constraint, a donation from a peripheral network member.
Number of living donor offers, accepting an offer.
We performed egocentric network analyses for all participants. Poisson regression models evaluated associations between network measures and number of offers. Logistic regression models determined the associations between network factors and accepting a donation offer.
The mean age of the 106 participants was 60 years. Forty-five percent were female, and 75% self-identified as Black. Fifty-two percent of participants received at least one living donor offer (range 1-6); 42% of the offers were from peripheral members. Participants with larger networks received more offers (incident rate ratio [IRR], 1.26; 95% CI, 1.12-1.42; = 0.001), including networks with more peripheral members (constraint, IRR, 0.97; 95% CI, 0.96-0.98; < 0.001). Participants who received a peripheral member offer had 3.6 times greater odds of accepting an offer (OR, 3.56; 95% CI, 1.15-10.8; = 0.02) than those who did not receive a peripheral member offer.
A small sample of only hemodialysis patients.
Most participants received at least one living donor offer, often from peripheral network members. Future living donor interventions should focus on both core and peripheral network members.
大多数活体肾供体是血液透析患者社交网络的成员。社交网络成员分为核心成员，即与患者及其他成员联系紧密的人；以及外围成员，即与患者及其他成员联系较弱的人。我们要确定有多少血液透析患者的社交网络成员主动提出成为肾供体，这些提议是来自核心还是外围网络成员，以及患者接受了谁的提议。
一项由访员进行的横断面血液透析患者社交网络调查。
两家机构中的现患血液透析患者。
社交网络规模和约束性、来自外围网络成员的捐赠。
活体供体提议的数量、接受提议。
我们对所有参与者进行了自我中心网络分析。泊松回归模型评估了网络指标与提议数量之间的关联。逻辑回归模型确定了网络因素与接受捐赠提议之间的关联。
106名参与者的平均年龄为60岁。45%为女性，75%自我认定为黑人。52%的参与者至少收到过一次活体供体提议（范围为１至６次）；42%的提议来自外围成员。社交网络规模较大的参与者收到的提议更多（发生率比[IRR]，1.26；95%置信区间，1.12 - 1.42；P = 0.001），包括外围成员较多的社交网络（约束性，IRR，0.97；95%置信区间，0.96 - 0.98；P < 0.001）。收到外围成员提议的参与者接受提议的几率是未收到外围成员提议者的3.6倍（优势比，3.56；95%置信区间，1.15 - 10.8；P = 0.02）。
仅以血液透析患者为小样本。
大多数参与者至少收到过一次活体供体提议，且提议通常来自外围网络成员。未来的活体供体干预措施应同时关注核心和外围网络成员。
