Inequitable Access to Living Donor Kidney Transplantation in Black and Asian Minority Ethnic Groups in the UK: A Single Centre Cross-Sectional Cohort Study
Guy's and St. Thomas' Hospital, London, United Kingdom
Meeting: 2020 American Transplant Congress
Abstract number: D-202
Keywords: African-American, Donation, Ethics, Kidney transplantation
Session Information
Session Name: Poster Session D: Non-Organ Specific: Disparities to Outcome and Access to Healthcare
Session Type: Poster Session
Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
Location: Virtual
*Purpose: Black, Asian and Minority Ethnic (BAME) communities constitute 11% of the UK population, yet represent 31% of the national kidney transplant waiting list. Moreover, in our ethnically diverse unit BAME patients comprise over 50% of those registered waiting for a kidney transplant. Initiatives to address this disparity are underway and include promotion of living donor kidney transplantation (LDKT) in BAME. However, currently approximately one third of all kidney transplants in the UK are from living donors and BAME living donors represent only 14% of all living donors. The purpose of this study was to (i) assess BAME representation in our large ethnically diverse LDKT cohort (ii) identify and implement key strategies to promote LD in BAME.
*Methods: We undertook a retrospective cross-sectional cohort study of all living related and unrelated adult kidney transplants performed at our unit between 01/01/2010 and 01/08/2015.
*Results: 537 LDKT were performed in our unit within the 5-year study period. 62% of recipients were male. Mean recipient age at transplant was 45.2 years. Mean living donor age was 45.0 years. 79.9% of LD recipients were white. In comparison 47% of patients active on our deceased donor transplant list are white. Of the BAME recipient group, 9.9% were Black, 5.8% Asian, 0.74% mixed race, 1.3% Chinese/Oriental, 2.4% other. In comparison, patients active on our deceased donor transplant list are 33% Black and 10% Asian.
| Ethnic Group | ||||||
| White | Black | Asian | Mixed | Chinese | Other | |
| LU KT | 45% | 34% | 45% | 50% | 57% | 23% |
| PooledAltruisticSpousePartnerOther | n = 8 | n = 2 | n = 1 | – | – | n = 1 |
| n = 26 | n = 4 | n = 2 | – | – | – | |
| n = 84 | n = 7 | n = 7 | n = 1 | n = 3 | – | |
| n = 17 | n = 1 | – | n = 1 | n = 1 | – | |
| n = 48 | n = 4 | n = 2 | – | – | n = 1 | |
| LR KT | 55% | 66% | 55% | 50% | 43% | 77% |
| SiblingParentSon/daughterOther | n=104 | n=17 | n= 6 | n = 1 | – | n = 5 |
| n = 60 | n = 2 | n = 3 | n = 1 | n = 1 | n = 2 | |
| n = 49 | n = 8 | n = 6 | – | n = 2 | n = 3 | |
| n = 23 | n = 8 | n = 2 | – | – | – |
*Conclusions: According to national figures, our unit performs more than the average BAME LDKT. Nevertheless, our data highlights significant under representation of BAME communities in our LDKT programme and brings inequity of access to transplantation into focus. Understanding our BAME patient cohort and intercultural differences is key to overcoming these challenges and improving access to LDKT for BAME communities. Since conducting this analysis we have facilitated peer support to increase awareness of and improve access to LDKT in our BAME community. A further 3- year cohort analysis following this implementation is now underway.
To cite this abstract in AMA style:
Cronin A, Sran K, Gokmen R, Copley A, Silas L, Zakri R. Inequitable Access to Living Donor Kidney Transplantation in Black and Asian Minority Ethnic Groups in the UK: A Single Centre Cross-Sectional Cohort Study [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/inequitable-access-to-living-donor-kidney-transplantation-in-black-and-asian-minority-ethnic-groups-in-the-uk-a-single-centre-cross-sectional-cohort-study/. Accessed May 16, 2025.« Back to 2020 American Transplant Congress