Background: Prior studies have shown that transplant candidates who are minorities and less educated are less willing to talk to others about living kidney donor (LKD) transplants. We assessed recipient attitudes toward asking for and accepting offers from potential LKDs.

Methods: We conducted a single-center, prospective study of patients initiating evaluation for kidney transplantation. Participants completed surveys at the clinic appointment and an interview several days later to assess their attitudes toward LKDs. We used a major and minor coding method to analyze our qualitative data in NVivo11. Standard descriptive statistics evaluated demographic factors associated with willingness to ask for or accept a LKD offer.

Results: Thirty-nine transplant candidates completed interviews (response rate 51%). The mean age was 55 years; 54% were male, 49% had a high school education or less, 31% earned <$25,000/year, and 54% were on dialysis (mean 2.3 years). There were 54% whites, 39% African-Americans, and 9% other races or not reported.

Before evaluation, 55% had considered living donor kidney transplantation. By the interview, 61% had received an unsolicited LKD offer. Only 18% had asked someone to consider donating, 71% of whom received subsequent offers. Of those who received a LKD offer, 81% would accept it. Recipient demographics, including race and education, were not correlated with having a potential LKD at evaluation, receiving a LKD offer, or asking someone to donate.

The major barrier to asking for a LKD or from accepting a LKD offer was risk to donors (30%): “I'd be very sad to take a kidney from one of my loved ones and have to worry that one day they're going to need one.” Others described social discomfort (16%): “I haven't [asked] yet. It's rather awkward.” Additional factors driving reluctance toward asking included poor health status of potential LKDs (26%) and negative impacts on relationships (8%). Refusal to accept a LKD offer was motivated by uncertainty about the transplant outcome (16%), insufficient knowledge about the procedure (16%), and reservations about the seriousness of the offer (16%).

Conclusion: Few patients were comfortable soliciting LKDs. Race and socioeconomic factors were not barriers to asking for or accepting LKD offers. Candidates' concerns highlight opportunities for transplant centers to provide further information about donor risks to foster recipient self-advocacy.

CITATION INFORMATION: Yu K, Kulkarni S, Gannon J, Reese P, Gordon E, Thiessen C. Attitudes Toward Living Kidney Transplantation Among Potential Transplant Candidates. Am J Transplant. 2016;16 (suppl 3).

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