Department of Sociology and Criminology, The Pennsylvania State University, University Park, PA, USA.
Prog Transplant. 2023 Dec;33(4):310-317. doi: 10.1177/15269248231212913. Epub 2023 Nov 9.
Living donor discussions in which kidney transplant candidates discuss living kidney donation with their social network are an important step in the living donor kidney transplant process. No prior research has investigated whether who initiates discussion or influences evaluation agreement rates or how these processes may contribute to disparities. This study aimed to determine how common candidate- and potential-donor-initiated discussions were, at what rate each discussion type resulted in agreement to be evaluated for living donation, and what sociodemographic characteristics predicted living donor discussion and agreements. A 2015 cross-sectional survey at a single, large Southeastern US transplant center measured kidney transplant candidates' social networks, including whether they had a donor discussion, who initiated it, and whether the discussion resulted in the donor evaluation agreement. Candidate-network member pairs' probability of having a candidate-initiated discussion, potential-living donor-initiated discussion, or no discussions were compared in multinomial logistic regression, and the probability of the discussion resulted in evaluation agreement was evaluated in multinomial logistic regression. Sixty-six kidney transplant candidates reported on 1421 social network members. Most (80%) candidate/network-member pairs did not have a living donor discussion, with candidate-initiated discussions (11%) slightly more common than potential-donor-initiated discussions (10%). Evaluation agreement was much more common for potential-donor-initiated (72%) than for candidate-initiated discussions (39%). Potential-donor-initiated discussions were more common for White candidates (16%) than for Black candidates (7%). Potential-donor-initiated discussions resulted in evaluation agreement much more frequently than candidate-initiated discussions. This dynamic may contribute to racial living donation disparities.
在活体器官捐赠肾脏移植过程中，候选人和他们的社交网络讨论活体肾脏捐赠是一个重要的步骤。目前还没有研究调查过是候选者还是潜在捐赠者首先发起讨论，或者这些过程如何影响评估协议率，以及这些过程如何导致差异。本研究旨在确定候选者和潜在捐赠者发起的讨论有多常见，每种讨论类型导致同意接受活体捐赠评估的比例是多少，以及哪些社会人口特征预测了活体器官捐赠讨论和协议。2015 年，在一家位于美国东南部的大型移植中心进行了一项横断面调查，调查了肾脏移植候选者的社交网络，包括他们是否进行了捐赠者讨论、谁发起了讨论，以及讨论是否导致了捐赠者评估协议。在多项逻辑回归中比较候选者-网络成员对是否进行了候选者发起的讨论、潜在活体供者发起的讨论或没有讨论，并在多项逻辑回归中评估讨论导致评估协议的概率。66 名肾脏移植候选者报告了 1421 名社交网络成员。大多数（80%）候选者/网络成员对没有进行活体器官捐赠讨论，候选者发起的讨论（11%）略多于潜在供者发起的讨论（10%）。潜在供者发起的讨论比候选者发起的讨论更有可能导致评估协议（72%比 39%）。白人候选者（16%）比黑人候选者（7%）更有可能发起潜在供者的讨论。潜在供者发起的讨论更有可能导致评估协议，这一动态可能导致种族间活体捐赠的差异。
