Modifiable Barriers in Decision Making Around Living Donor Kidney Transplantation – A Rapid Scoping Review to Guide (DEAL-KD) Study
1Leeds Teaching Hospitals Trust, Leeds, United Kingdom, 2Division of Psychological and social Medicine, University of Leeds, Leeds, United Kingdom, 3Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
Meeting: 2021 American Transplant Congress
Abstract number: 958
Keywords: Donation, Kidney, Living donor
Topic: Clinical Science » Kidney » Kidney Living Donor: Other
Session Information
Session Name: Kidney Living Donor: Other
Session Type: Poster Abstract
Session Date & Time: None. Available on demand.
Location: Virtual
*Purpose: Living donor kidney transplantation (LDKT) is the optimal modality of renal replacement therapy for patients with advanced renal disease; associated with superior recipient and graft survival. LDKT offers better perceived quality of life and self-reported health status versus dialysis. The decision making can be complex; healthcare professionals convey information to patients but rely on the recipient to encourage potential donors to engage. LDKT occurs less frequently in Black and Minority Ethnic (BAME) groups compared to Caucasians. This rapid scoping literature review aims to identify modifiable barriers in the decision making to pursue LDKT with a focus on BAME populations
*Methods: 208 articles were identified from Pubmed and Medline using keywords; barriers, decision making, living donor, kidney transplantation. Studies focusing on donors, paediatric recipients and abstracts for conference purposes only, were excluded.
*Results: 25 studies were included; USA (15), Netherlands (3), Canada (3), New Zealand (3), UK (1). 18 studies, based in the USA (13), Netherlands (3), New Zealand (2) included BAME groups; African Americans (8), far East Asian (1) ,Hispanics (3) , and mixed other (6). South Asians were represented in one study, as 6% of the study sample. Key barriers identified were; 1) Lack of knowledge and insight into LDKT 2) Higher risk perception 3) Fear of financial burden on donors 4) Guilt for requiring a kidney and causing potential harm 5) Religious and cultural reservations.
*Conclusions: This literature review provides a global perspective on modifiable barriers to decision making in pursuing LDKT. This review will inform The Decision Around Living Kidney Donation (DEAL-KD) study (ref: KRY 19-127) to create a patient decision aid to address these perceptions and facilitate engagement with particular focus on South Asian groups the second largest ethnic group in the UK. Further exploration of stakeholder views will enable the development of a culturally sensitive, evidence-based resource
To cite this abstract in AMA style:
Ahmed A, Winterbottom A, Ahmed S, Stoves J, Daga S. Modifiable Barriers in Decision Making Around Living Donor Kidney Transplantation – A Rapid Scoping Review to Guide (DEAL-KD) Study [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/modifiable-barriers-in-decision-making-around-living-donor-kidney-transplantation-a-rapid-scoping-review-to-guide-deal-kd-study/. Accessed May 11, 2025.« Back to 2021 American Transplant Congress