Testing the Differential Access Hypothesis That Black Kidney Transplant Candidates Perceive Social Network Access to Fewer Potential Living Donors Than White Candidates.
Jonathan Daw, Mary Roberts, Avrum Gillespie and 2 others
PMID 36942427WHAT IT FOUND
Black and White kidney transplant candidates reported similar chances of having at least one healthy, willing person in their social network.
Differences seen before accounting for age, sex, education, and network member age, sex, and relationship disappeared after accounting for them.
Key findings
01Black and White candidates reported similar candidate-level access to at least one suitable network member, with 96% of White and 100% of Black candidates reporting at least one healthy member, and no statistically significant differences across five indicators.
02At the network-member level, unadjusted comparisons found Black candidates rated more members healthy (57% vs 47%) and healthy & likely (26% vs 21%), while White candidates rated more members agreed (13% vs 9%), but demographic adjustment removed these race differences.
03In nuclear-family-only checks, White candidates' network members agreed at higher rates (28% vs 18%, P = .018), but no other differences were significant.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 66 candidates were analysed from a single southeastern United States transplant centre, and recruitment was convenience sampling. Candidates reported other people's health and donation willingness, not medical records or donor self-reports. The study did not follow network members through living-donor evaluation or donation, so it cannot show why actual living-donor rates differ. Race and age distributions were similar but not identical to the centre, region, or United States. Missing network-member answers were imputed, and nonresponse was higher for network items than candidate items.
Declared interests
Funding came from NIDDK grant R01DK114888, the University of Alabama at Birmingham Comprehensive Transplant Institute, the Penn State Social Science Research Institute, and the Penn State Population Research Institute, supported by Eunice Kennedy Shriver National Institute of Child Health and Human Development infrastructure grant P2CHD041025.
The easy way to misread this
Do not conclude that Black kidney transplant candidates have fewer suitable potential living donors. The study found no candidate-level differences, and network-member differences were not significant after demographic adjustment; it also measured candidate perceptions in one centre, not donor evaluations.