Immigrant, racialized status may affect pursuit of living donor kidney transplant
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Key takeaways:
- Patients of racialized immigrant status were less likely to discuss living donor kidney transplant.
- In addition, the patients were also less likely to identify a potential donor.
Immigrant and racialized status may affect readiness to pursue living donor kidney transplant, according to results of a study.
“Ethnocultural and socioeconomic factors and racialization are associated with lower utilization of [living donor kidney transplant] LDKT,” Eric Lui, and Jasleen Gill, of the University of Toronto, wrote with colleagues. “Gaps in transplant-related knowledge and the impact of systemic racism and medical mistrust contribute to these inequities.”
While many U.S. studies have assessed motivation and the readiness to pursue living donor transplant among Black patients, the researchers wrote, “this has not been well-studied outside of the United States, or for Asian communities.”
The term “racialization” was used in the study to emphasize historical, social and political processes that form racialized categories, according to the researchers. It “indicates that the processes forming and reinforcing those categories are, frequently and to a large extent, driven and informed by values, judgments, biases and sociopolitical structures external to the affected individuals and groups,” they wrote.
Researchers evaluated 498 patients with kidney failure in Toronto, Canada, gathered from the Comprehensive Psychosocial Research Data System. Overall, 281 patients were of immigrant status; 142 were African, Caribbean and Black; 123 were Asian; and 233 were white.
Researchers assessed five main patient outcomes, including having spoken with others about living donor kidney transplant; identifying a potential living donor; allowing others to share the need for living donor kidney transplant; asking a potential donor to be tested; and accepting a hypothetical transplant offer from a living donor.
Compared with white nonimmigrant patients, researchers found that patients of racialized immigrant and racialized nonimmigrant status were less likely to have spoken about living donor kidney transplant with others or having planned to do so. Patients of racialized immigrant and racialized nonimmigrant status, as well as white patients of immigrant status, were less likely to find a living donor.
“Lower willingness to engage in communication with potential donor candidates may contribute to lower access to LDKT among immigrant and racialized patients with kidney failure,” the researchers wrote. “An important next step is to develop strategies and tools to better support patients from these communities to reduce inequities in accessing the best treatment for kidney failure [that] build on an enhanced understanding of the barriers patients from these communities may face when exploring their treatment options.”
Importantly, they added, “due to experiences with racism and discrimination both within and outside the health care system, efforts to increase readiness of patients from racialized communities in engaging the pursuit of LDKT can only be successful if they are co-designed with the communities affected, and delivered by trusted individuals, preferably community members with lived experience of kidney failure and transplant.”
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