Racial Differences in the Living Kidney Donation Experience and Implications for Education

Abstract

Context

Much has been written about the barriers to deceased organ donation in the African American community. However, relatively little research has been conducted on barriers to living donation among African Americans. A shortage of suitable deceased donor kidneys among African Americans has encouraged donation from living donors.

Objective

As a follow-up to several focus groups with health professionals about barriers to living donation and suggestions for educational interventions, we sought to determine kidney donors' thoughts and feelings about their donation.

Design

Telephone interviews with past donors.

Participants

Nine African Americans and 9 whites were selected from a database of laparoscopic donor nephrectomies from 1993 to 2003.

Outcome Measures

Transcribed phone interviews were reviewed by 3 researchers to determine recurring themes and categorize responses.

Results

Responses were categorized into 8 areas of concern: health, financial, life with 1 kidney, procreation, psychosocial matters, surgery related, success of the transplant, and concerns about the future. Whites (n =9) tended to volunteer more for laparoscopic kidney donation than did African Americans (n = 2). African American concerns focused on future health and living with only 1 kidney, whereas whites had concerns about the surgery and the medical system.

Conclusions

Findings indicated that education is the best way to reach living donors and dispell fears. Promoting general health of African Americans may increase their willingness to be a living donor. Altruistic motives are the main motivation for donation, and intervention programs should target groups on a personal level to help individuals see that they can make a difference in improving or saving lives.

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References

Sanner

. The donation process of living kidney donors. Nephrol Dial Transplant. 2005;20(8):1707–1713.

Berney

Malaise

Mourad

Morel

Squifflet

. Laparoscopic and open live donor nephrectomy: A cost/benefit study. Transpl Int. 2000;13(1):35–40.

Eberhard

Kliem

Offner

. Assessment of long-term risks for living related kidney donors by 24-h blood pressure monitoring and testing for microalbuminuria. Clin Transplant. 1997;11(5 pt 1):415–419.

Goldfarb

Matin

Braun

. Renal outcome 25 years after donor nephrectomy. J Urol. 2001;166(6):2043–2047.

Jakobsen

Holdaas

Leivestad

. Ethics and safety of living kidney donation. Transplant Proc. 2003;35(3):1177–1178.

Taghavi

Mahdavi

Toufani

. The psychological effects of kidney donation on living kidney donors (related and unrelated). Transplant Proc. 2001;33(5):2636–2637.

Schover

Streem

Boparai

Duriak

Novick

. The psychosocial impact of donating a kidney: Long-term follow-up from a urology based center. J Urol. 1997;157(5):1596–1601.

Olbrisch

Benedict

Haller

Levenson

. Psychosocial assessment of living organ donors: Clinical and ethical considerations. Prog Transplant. 2001;11(1):40–49.

Fahrenwald

Stabnow

. Sociocultural perspective on organ and tissue donation among reservation-dwelling American Indian adults. Ethn Health. 2005;10(4):341–354.

10.

Spigner

Weaver

Cardenas

Allen

. Organ donation and transplantation: Ethnic differences in knowledge and opinions among urban high school students. Ethn Health. 2002;7(2):87–101.

11.

Cass

Cunningham

Snelling

Wang

Hoy

. Renal transplantation for Indigenous Australians: Identifying the barriers to equitable access. Ethn Health. 2003;8(2):111–119.

12.

Najarian

. Living donor kidney transplants: Personal reflections. Transplant Proc. 2005;37(9):3592–3594.

13.

Andersen

Mathisen

Oyen

Wahl

Hanestad

Fosse

. Living donors' experiences 1 wk after donating a kidney. Clin Transplant. 2005;19(1):90–96.

14.

Neuhaus

Wartmann

Weber

Landolt

Laube

Kemper

. Psychosocial impact of living–related kidney transplantation on donors and partners. Pediatr Nephrol. 2005;20(2):205–209.

15.

Cabrer

Oppenhaimer

Manyalich

. The living kidney donation process: The donor perspective. Transplant Proc. 2003;35(5):1631–1632.

16.

Shilling

Norman

Chavin

. Healthcare professionals' perceptions of the barriers to living donor kidney transplantation among African Americans. J Natl Med Assoc. 2006;98(6):834–840.

17.

Strauss

Corbin

. Basics of Qualitative Research Newbury Park, CA: Cage; 1990.

18.

Golafshani

. Understanding reliability and validity in qualitative research. The Qualitative Report. 2003;8(4):597–607.

19.

Patton

. Qualitative Evaluation and Research Methods. 3rd ed. Beverly Hills, CA: Sage; 2001.

20.

Shilling

Norman

Chavin

. Health care professionals' perceptions of the barriers to living donor kidney transplantation among African Americans. J Natl Med Assoc. 2006;98(6):834–840.

21.

Aghanwa

Akinsola

Akinola

Makanjuola

. Attitudes toward kidney donation. J Natl Med Assoc. 2003;95(8):725–731.

22.

Hilhorst

Kranenburg

Zuidema

. Altruistic living kidney donation challenges psychosocial research and policy: A response to previous articles. Transplantation. 2005;79(11):1470–1474.

23.

Arriola

Jacob KR

Perryman

Doldren

. Moving beyond attitudinal barriers: Understanding African Americans' support for organ and tissue donation. J Natl Med Assoc. 2005;97(3):339–350.

24.

Johnson

. Some of the challenges of encouraging organ donation among minority populations. N C Med J. 2004;65(1):35–36.

25.

Minniefield

Yang

Muti

. Differences in attitudes toward organ donation among African Americans and whites in the United States. J Natl Med Assoc. 2001;93(10):372–379.

26.

Lunsford

Simpson

Chavin

. Racial differences in coping with the need for kidney transplantation and willingness to ask for live organ donation. Am J Kidney Dis. 2006;47(2):324–331.