Self-advocacy is associated with lower likelihood of living donor kidney transplantation

Affiliations

¹ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: akale@uabmc.edu.
² University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: rdeierhoi@uabmc.edu.
³ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: alexiscarter@uabmc.edu.
⁴ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: marshallcmcleod@uabmc.edu.
⁵ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: brittanyshelton@uabmc.edu.
⁶ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: vkumar@uabmc.edu.
⁷ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: hyqu@uab.edu.
⁸ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: pmaclennan@uabmc.edu.
⁹ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: borandi@uabmc.edu.
¹⁰ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: rmcannon@uabmc.edu.
¹¹ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: douglasanderson@uabmc.edu.
¹² University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: mhanaway@uabmc.edu.
¹³ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: jlocke@uabmc.edu.

PMID: 33413873
PMCID: PMC8217080
DOI: 10.1016/j.amjsurg.2020.12.035

Self-advocacy is associated with lower likelihood of living donor kidney transplantation

A Cozette Killian et al. Am J Surg. 2021 Jul.

. 2021 Jul;222(1):36-41.

doi: 10.1016/j.amjsurg.2020.12.035. Epub 2020 Dec 24.

Authors

Affiliations

¹ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: akale@uabmc.edu.
² University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: rdeierhoi@uabmc.edu.
³ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: alexiscarter@uabmc.edu.
⁴ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: marshallcmcleod@uabmc.edu.
⁵ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: brittanyshelton@uabmc.edu.
⁶ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: vkumar@uabmc.edu.
⁷ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: hyqu@uab.edu.
⁸ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: pmaclennan@uabmc.edu.
⁹ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: borandi@uabmc.edu.
¹⁰ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: rmcannon@uabmc.edu.
¹¹ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: douglasanderson@uabmc.edu.
¹² University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: mhanaway@uabmc.edu.
¹³ University of Alabama at Birmingham Comprehensive Transplant Institute, 701 19th Street South, LHRB 790, Birmingham, AL, 35233, USA. Electronic address: jlocke@uabmc.edu.

PMID: 33413873
PMCID: PMC8217080
DOI: 10.1016/j.amjsurg.2020.12.035

Abstract

Background: The Living Donor Navigator (LDN) Program pairs kidney transplant candidates (TC) with a friend or family member for advocacy training to help identify donors and achieve living donor kidney transplantation (LDKT). However, some TCs participate alone as self-advocates.

Methods: In this retrospective cohort study of TCs in the LDN program (04/2017-06/2019), we evaluated the likelihood of LDKT using Cox proportional hazards regression and rate of donor screenings using ordered events conditional models by advocate type.

Results: Self-advocates (25/127) had lower likelihood of LDKT compared to patients with an advocate (adjusted hazard ratio (aHR): 0.22, 95% confidence interval (CI): 0.03-1.66, p = 0.14). After LDN enrollment, rate of donor screenings increased 2.5-fold for self-advocates (aHR: 2.48, 95%CI: 1.26-4.90, p = 0.009) and 3.4-fold for TCs with an advocate (aHR: 3.39, 95%CI: 2.20-5.24, p < 0.0001).

Conclusions: Advocacy training was beneficial for self-advocates, but having an independent advocate may increase the likelihood of LDKT.

Keywords: Advocacy; Disparities in LDKT; Living donor kidney transplantation (LDKT); Navigator program; Transplantation.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors declare no conflicts of interest.

Comment in

Why is self-advocacy a barrier to living donor kidney transplantation?
Wall AE. Wall AE. Am J Surg. 2021 Jul;222(1):35. doi: 10.1016/j.amjsurg.2021.01.042. Epub 2021 Feb 4. Am J Surg. 2021. PMID: 33612256 No abstract available.

References

1. United States Renal Data System Annual Data Report: Epidemiology of kidney disease in the United States. 2017.
1. Organ Procurement and Transplantation Network National Data Reports. http://optn.transplant.hrsa.gov/. Published 2019. Accessed 3/8/2020.
1. Tullius SG, Rabb H. Improving the Supply and Quality of Deceased-Donor Organs for Transplantation. N Engl J Med. 2018;378(20):1920–1929. - PubMed
1. Orandi BJ, Luo X, Massie AB, et al. Survival Benefit with Kidney Transplants from HLA-Incompatible Live Donors. N Engl J Med. 2016;374(10):940–950. - PMC - PubMed
1. Survey Shows Public Says “Yes” to Strangers. [press release]. National Kidney Foundation; 2000.

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Self-advocacy is associated with lower likelihood of living donor kidney transplantation

Affiliations

Self-advocacy is associated with lower likelihood of living donor kidney transplantation

Authors

Affiliations

Abstract

Conflict of interest statement

Comment in

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Medical