*Purpose: The psychosocial evaluation of transplant candidates is a comprehensive assessment of the (Fig 1). Psychosocial risk factors can be the only basis for not listing or de-listing a patient. We aimed to assess whether there is an association between race and evaluation closure for psychosocial risk factors.

*Methods: This retrospective cohort study included all kidney transplant evaluations performed at a single center from 2014-2018. Patient demographics and reason for evaluation closure were abstracted from the medical record. The primary outcome of interest was evaluation closure because of psychosocial clearance factors.

*Results: There were n= 3,593 kidney transplant evaluations performed during the study period, n= 2,393 for White patients and n=688 for Black patients. Of these, n=2,191 evaluations were closed. There were 38 discrete reasons for evaluation closure in the record with 6 corresponding to discrete psychosocial clearance concerns. The rate of closure for psychosocial clearance factors was 11.5% (95% CI, 10.0%,13.3%) for White patients and 19.3% (95% CI, 15.7%,23.4%) for Black patients. In an adjusted multilevel model accounting for patient characteristics, Black patients being evaluated for kidney transplantation had a statistically significant higher risk to have their evaluation closed for psychosocial clearance factors with an odds ratio (OR) of 1.64 (95%CI, 1.08, 2.51) compared to White patients (p<0.05).

*Conclusions: These results highlight a great disparity in the outcome of the psychosocial kidney transplant evaluation which likely reflects the higher structural disadvantage faced by Black patients with end-stage kidney disease.

« Back to 2022 American Transplant Congress