23 Jan Despite 20 Years of Programs and Policies, Racial Disparities in Kidney Transplants Widen

Posted at 00:45h in Author Interviews, JAMA, Johns Hopkins, Kidney Disease, Transplantation by

MedicalResearch.com Interview with:

Tanjala S. Purnell, PhD MPH Assistant Professor of Surgery, Epidemiology, and Health Behavior and Society Core Faculty, Epidemiology Research Group in Organ Transplantation Johns Hopkins University Associate Director for Education and Training, Johns Hopkins Center for Health Equity Member, OPTN/UNOS Minority Affairs Committee

Dr. Purnell

Tanjala S. Purnell, PhD MPH
Assistant Professor of Surgery, Epidemiology, and Health Behavior and Society
Core Faculty, Epidemiology Research Group in Organ Transplantation
Johns Hopkins University
Associate Director for Education and Training, Johns Hopkins Center for Health Equity
Member, OPTN/UNOS Minority Affairs Committee 

MedicalResearch.com: What is the background for this study?

  • Our study was motivated by the fact that we know live donor kidney transplants are associated with longer life expectancy and higher quality of life than deceased donor kidney transplants or long-term dialysis treatment. We also know that Black and Hispanic adults are more likely than White adults to have end-stage kidney disease but are less likely than White patients to receive live donor kidney transplants.
  • Over the last 2 decades, there have been several transplant education programs implemented within transplant centers and dialysis centers, and legislative policies enacted to improve overall access to live donor kidney transplants for patients. We wanted to see whether these programs and policies resulted in narrowed racial and ethnic disparities in access to live donor kidney transplants in the United States. 

MedicalResearch.com:? What are the main findings?

Response: We found that in spite of the existing programs and policies that have been enacted over the last 20 years, racial and ethnic disparities in live donor kidney transplantation have actually gotten much worse.

This finding was surprising and disappointing.

 MedicalResearch.com: What should readers take away from your report?

Response: It is important for patients to have early conversations about the benefits and risks of live donor kidney transplantation with their doctors and family members. These conversations may be important for alleviating concerns about transplantation and donation. Timely conversations with family members and friends about their need for a kidney transplant may also help to overcome documented barriers to identifying potential donors.   

MedicalResearch.com: What should readers take away from your report? 

Response:      It is important for patients to have early conversations about the benefits and risks of live donor kidney transplantation with their doctors and family members.

Timely conversations with family members and friends about their need for a kidney transplant may also help to overcome documented barriers to identifying potential donors.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response:  It is time for us to implement effective national strategies that specifically target racial and ethnic disparities in live donor kidney transplantation.  For example, national policy changes in the distribution of organs from deceased donors recently resulted in narrowed disparities in the receipt of transplants from deceased donors for Black and Hispanic patients. We should now identify effective national strategies to narrow persistent disparities in transplants from live donors. 

Citation:

JAMA. 2018 Jan 2;319(1):49-61. doi: 10.1001/jama.2017.19152.

Association of Race and Ethnicity With Live Donor Kidney Transplantation in the United States From 1995 to 2014.

Purnell TS1,2,3,4, Luo X1, Cooper LA2,3,4,5, Massie AB1,2, Kucirka LM1,2, Henderson ML1, Gordon EJ6, Crews DC4,7, Boulware LE8, Segev DL1,2.

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Last Updated on January 23, 2018 by Marie Benz MD FAAD

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