Barriers to Living Donor Kidney Transplant in the Pediatric Population.
1Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI
2Department of Psychiatry and Behavioral Neurosciences and Department of Anesthesiology, Wayne State University School of Medicine, Detroit, MI
3Division of Pediatric Nephrology and Hypertension, Wayne State University School of Medicine, Detroit, MI.
Meeting: 2016 American Transplant Congress
Abstract number: D165
Keywords: Donation, Kidney, Pediatric, Psychosocial
Session Information
Session Name: Poster Session D: Kidney-Pediatrics
Session Type: Poster Session
Date: Tuesday, June 14, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Objective:
A shift from living donor transplants to deceased donor transplants has been noted nationwide and is more prominent at some centers than others. Our objective is to study factors that influence access to live donor kidney transplants in children.
Methods:
Retrospective chart review was conducted for 91 children at an urban pediatric transplant center. All patients who received a kidney transplant or underwent pre-transplant work-up between 2005-2015 at Children's Hospital of Michigan were included. Excluded were re-transplantation patients and those with incomplete data. Psychosocial evaluation was performed in all patients before transplant and if indicated, they were referred for comprehensive psychological evaluation. Demographic information along with self-reported barriers to live donation were collected. Data were reported as percentages and analyzed using chi square test, p<0.05 was considered as significant.
Results:
Of the 91 children studied, 69% were male with mean age at time of transplant of 11.9 years. Ethnicity of subjects included 54% African American, 32% Caucasian, 8% Arabic, 3% Hispanic and 3% Others. 73% of subjects utilized government insurance (Medicaid/Medicare) while 27% utilized private insurance. 49% reported dual caregivers vs. 51% with a single caregiver. Of the 91 children studied, 68 received a kidney transplant; only 9 (13%) were from live donors. In living donor transplants, 11% were AA patients as compared to 59% in deceased donor transplants (p=0.01); 56% of live donor recipients had private insurance compared to 25% of deceased donor recipients with private insurance (p=0.07). Of all children who received live donor transplants, 78% were from dual caregiver families (p = 0.07). Reported hurdles to live donor kidney transplant included physical, health related, financial, caregiver psychiatric concerns, religious, and cultural barriers.
Conclusion:
In our pediatric population, the disparities noted in living donor transplants include ethnicity, individual factors related to socio-economic status, and caregiver constraints. The self-reported barriers to living donor transplant in this study may be amenable to positive intervention.
CITATION INFORMATION: Taormina S, Galloway M, Jain A. Barriers to Living Donor Kidney Transplant in the Pediatric Population. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Taormina S, Galloway M, Jain A. Barriers to Living Donor Kidney Transplant in the Pediatric Population. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/barriers-to-living-donor-kidney-transplant-in-the-pediatric-population/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress