Gender disparities uncovered in desire to receive living donor kidney transplants

Among black kidney failure patients undergoing dialysis, women are much less likely than men to want to receive kidney transplants from living donors, despite more offers from family and friends. The findings, which are from a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN), suggest that interventions are needed to increase women's acceptance of living donor kidney transplantation.

Living donor kidney transplantation is the treatment of choice for patients with kidney failure, but disparities exist among certain groups including blacks and women. Recent research into such disparities has focused primarily at the transplant clinic level, but disparities might be underestimated when only patients undergoing transplant evaluations are studied.

For this reason, Avrum Gillespie, MD (Temple University School of Medicine) and his colleagues looked for disparities in dialysis clinics and included patients both potentially eligible and ineligible for receiving a transplant. "Information gained about the concerns and attitudes of hemodialysis patients regarding living donor kidney transplantation might help us develop targeted interventions designed to alleviate some existing disparities," said Dr. Gillespie.

The research team administered a transplant questionnaire to 116 patients in two urban, predominantly black hemodialysis units. Among the major findings:

• Women were less likely to want to undergo living donor kidney transplantation compared with men (58.5% vs 87.5%) despite being nearly twice as likely as men to receive unsolicited offers for kidney transplants from family and friends (73.2% vs 43.2%).
• Women were also less likely to have been evaluated for a kidney transplant (28.3% vs 52.2%).
• After controlling for various factors known to influence transplant decisions, women were 87% less likely to want to undergo living donor kidney transplantation than men.

"To help improve the gender disparities in living donor kidney transplantation, future work is needed to learn how to support and encourage women to accept transplants," said Dr. Gillespie.