NIV Congres

Objective Despite living donor kidney transplantation (LDKT) being the optimal treatment option for patients with end-stage renal disease, we observed a significant inequality in the number of LDKT performed between patients of non-Western European and Western European origin. The aim of this study was to explore modifiable hurdles to LDKT thatmay help explain this inequality.

Methods A questionnaire on knowledge, risk perception, communication, subjective norm, and willingness towards LDKT was completed by 160 end-stage renal patients who were referred to the pre-transplantation outpatient clinic (participation rate 92%) prior to their consultation with the nephrologist. The questionnaire was available in 9 languages. Multivariate analyses of variance and binary regression analyses were conducted to explore and explain differences between patients with and without a living donor controlling for socio-demographic factors.

Results There were significantly fewer patients of non-Western descent (11/82) that brought a living donor to the outpatient clinic than patients of Western descent (38/78). Patients without a living donor were less likely to be employed than patients with a living donor (p<0.001). Furthermore, patients without a living donor were undergoing haemodialysis more often (p=0.003) and spent on average 15 to 23 months longer on dialysis (p=0.002) compared to those with a living donor. Non-Western descent, long duration of dialysis, low knowledge, little communication on kidney disease and low willingness to communicate with individuals from the social network were significantly related to the absence of a living donor.

Conclusions After correcting for non-modifiable socio-demographic factors, knowledge, willingness to communicate and actual communication were identified as modifiable factors that are related to the likelihood that a patient brings a potential living donor to the first visit at the pre-transplantation clinic. This observation makes knowledge and communication strong candidates to address in interventions aiming to reduce the inequality in LDKT among potential transplant candidates.