Short-Term Impact of an Educational Program Promoting Live Donor Kidney Transplantation in Dialysis Centers

Abstract

Context Given the shortage of kidneys available for transplantation, a community-based intervention trial was implemented to assess the impact of an educational program on patients' access to live donor kidney transplantation (LDKT). Objective To compare the short-term impact of a basic intervention and an enhanced intervention on patients' readiness to pursue LDKT. Design Baseline data and data from 1 week after interventions were analyzed. Participants 214 transplant-eligible hemodialysis patients attending 14 dialysis facilities in Maryland, Virginia, and Pennsylvania. Interventions In the basic intervention, 107 patients watched a 10-minute videotape on the experience of recipients and live donors of a kidney. In the enhanced intervention, 107 patients watched the same videotape and had a discussion with a health educator on the risks and benefits of LDKT, who could be a donor, and how to address the barriers they were encountering when seeking a live kidney donor. Main outcome measure Patient reported whether they were considering LDKT, had talked with family or friends about LDKT, and had asked someone for a kidney. Results Over half of transplant-eligible patients were not pursuing LDKT at baseline (64% in the basic intervention group, 61% in the enhanced intervention group). One week after the intervention, the odds of considering LDKT were higher among African Americans (odds ratio [OR], 2.28; confidence interval [CI], 1.22–4.25), younger patients (OR, 0.94; CI, 0.91–0.97), and patients who spent less time on dialysis (OR, 0.90; CI, 0.83–0.97). The odds of asking for a kidney were higher among African Americans (OR, 4.94; CI, 2.54–9.60) and patients who perceived they were in poor to fair health (OR, 3.30; CI, 1.12–9.67). Conclusions Although both interventions helped patients consider LDKT and ask for a kidney, more time and expanded educational content might be needed to facilitate patients' discussion about LDKT with their loved ones.