Reducing Disparities in Living Donor Transplant Among African Americans

For most of the patients in the United States with end stage renal disease (ESRD), kidney
transplantation represents the optimal treatment. Moreover, living donor kidney
transplantation (LDKT) offers numerous advantages such as better kidney quality, increased
short- and long-term graft survival, lower rates of acute rejection, and reduced health care
cost. Nevertheless, there are pervasive racial disparities in access to LDKT, with white ESRD
patients four times more likely to receive a LDKT than African American ESRD patients. The
main outcome of this study is change in the proportion of study participants who have at
least one living donor inquiry by friends/family over 12 months from baseline.The long-term
objective is to understand the combined effect of a systems-level intervention that enhances
communication between dialysis facility and transplant center clinicians (Transplant Referral
EXchange or T-REX) and a culturally-sensitive individual-level educational intervention
(web-based Living ACTS: About Choices in Transplantation and Sharing) on racial disparities
in access to LDKT.

Inclusion Criteria:

- All patients referred (from dialysis facility, chronic kidney disease clinic, or self)
and scheduled for an evaluation at one of the four study sites within the study time
period.

- African American or Black

- age 18 to 65 years

- BMI < 35

- English-speaking