NDT Advance Access originally published online on May 15, 2006
Nephrology Dialysis Transplantation 2006 21(9):2569-2576; doi:10.1093/ndt/gfl218
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Original Articles: Dialysis and Transplantation
The influence of socio-demographic factors, treatment perceptions and attitudes to living donation on willingness to consider living kidney donor among kidney transplant candidates
1 Department of Medicine, Division of Nephrology, University of Ottawa and the Kidney Research Centre of the Ottawa Hospital Research Institute at the Ottawa Hospital, Riverside Campus, Ottawa, ON K1H 7W9 and 2 Department of Medicine, Division of Nephrology, University of Toronto, Toronto, ON M4N 3M5, Canada, 3 Department of Community and Family Medicine, Dartmouth Medical School, Dartmouth College, Hanover, NH 03755, USA, 4 Department of Medicine, Division of Rheumatology, University of Toronto, 5 Department of Health Policy, 6 Department of Management and Evaluation, 7 Department of Arthritis Community Research and Evaluation Unit, University Health Network Research Institute and 8 Institute for Clinical and Evaluative Sciences, Women's College Campus of Sunnybrook, Toronto, ON M5S 1B2, Canada
Correspondence and offprint requests to: Deborah Zimmerman, Assistant Professor, Department of Medicine, Division of Nephrology, University of Ottawa and the Kidney Research Centre of the Ottawa Hospital Research Institute at the Ottawa Hospital, Riverside Campus, 1967 Riverside Drive, Ottawa, ON K1H 7W9, Canada. Email: dzimmerman{at}ottawahospital.on.ca
Background. Living donor, compared with cadaveric donor kidney transplantation, is associated with prolonged graft survival and increased life expectancy for patients with end-stage renal disease (ESRD). However, access to living donor transplantation remains variable. Our objective was to further our understanding of the factors associated with the willingness to consider living donor kidney transplant (LDKTx).
Methods. All patients from two tertiary care hospitals being assessed for a LDKTx (n = 81), and a random sample of patients on the waiting list for a cadaveric kidney transplant (CDKTx, n = 133) were invited to participate. A mail survey assessed participants’ socio-demographic characteristics, and perceptions of dialysis, CDKTx and LDKTx. Multivariable logistic regression was used to assess the influence of these factors on willingness to consider LDKTx.
Results. Adjusting for patient age, employment status and number of close relatives, willingness to consider an LDKTx was independently associated with a lower perceived risk of peri-operative complications to the donor (adjusted OR 3.59, P = 0.02), the perception that the recipient would live longer following living donor transplantation (adjusted OR 4.34, P = 0.003) and greater perceived appropriateness of asking a family member to donate a kidney (adjusted OR 5.06, P = 0.007).
Conclusion. Among the ESRD patients studied, adjusting for key factors that may be associated with access to LDKTx, perceptions about risks to the donor and benefits to the recipient were independently associated with a willingness to consider LDKTx as a treatment option. Provision of standardized comprehensible information about all treatment options to patients with ESRD may improve acceptance rates for living donor transplantation.
Keywords: benefit; dialysis; living donor kidney transplantation; risk; willingness
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