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Keywords:

  • live donor kidney transplantation;
  • live kidney donation;
  • minority donation;
  • racial–ethnic disparities;
  • willingness to donate live kidneys

Abstract

Background

Reasons for US racial–ethnic minority ESRD patients’ reported difficulties identifying live kidney donors are poorly understood.

Methods

We conducted a national study to develop scales measuring willingness to donate live kidneys among US adults (scores ranged from 0 [not willing] to 10 [extremely willing]), and we tested whether racial–ethnic differences exist in willingness to donate. We also examined whether clinical, sociodemographic, and attitudinal factors mediated potential racial–ethnic differences in willingness.

Results

Among 845 participants, the majority were extremely willing to donate to relatives (77%) while fewer than half were extremely willing to donate to non-relatives (18%). In multivariable linear regression analyses, willingness to donate varied by race–ethnicity and recipient relationship to the donor. African Americans were less willing to donate to relatives than whites (β: −0.48; 95% CI [Confidence Interval]: −0.94 to −0.17; p = 0.04), but these differences were eliminated after accounting for socioeconomic factors, medical trust, and concerns about burial after death. There were no differences in willingness to donate between Hispanics and whites.

Conclusions

African Americans’ burial concerns, medical trust, and socioeconomic factors explained differences in their willingness to donate to relatives, suggesting efforts to address these barriers may enhance rates of live kidney donation in this group.