Racial minorities have higher rates of kidney failure than Whites but are less likely to receive kidney transplants. This study described each race/ethnic groups' level of transplant knowledge and decision-making then compared their knowledge and decision-making characteristics by race.

From 2013-2014, we surveyed 333 patients as they presented for transplant evaluation at two transplant centers in Los Angeles, CA and Houston, TX on their transplant knowledge, stage of readiness and confidence pursuing living and deceased donor kidney transplantation (LDKT and DDKT), and perceived Pros/Cons to LDKT/DDKT. Responses to knowledge and decision-making items were summed to create scales. We compared levels of these variables across patients of all races using ANOVA or chi-square tests. Finally, we adjusted for demographic/clinical variables in regression models of transplant knowledge, perceived Pros and Cons to transplant, and readiness and confidence to pursue DDKT and LDKT, with race as the primary predictor.

This patient sample was 30% Hispanic, 32% Black, and 38% White. On average, non-White patients had lower transplant knowledge and higher perceived Cons. In a linear regression model adjusting for gender, age, education level, and being on dialysis, Hispanics (b = -0.94; p=0.02) and Blacks (b = -0.97; p=0.005) had significantly lower transplant knowledge when first presenting for transplant evaluation compared to Whites. In a similar regression model, Hispanics (b = 2.35; p=0.02) and Blacks (b = 3.89; p<0.001) had higher perceived Cons to DDKT than Whites.

Black and Hispanic patients may need educational programs that better address their knowledge gaps and fears when beginning evaluation. The adoption of these types of programs might prepare them better, thus increasing DDKT and LDKT rates for these ethnic/racial groups.

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