Comparing Approaches to Improve Black Patients’ Chances of Getting Live Donor Kidney Transplants

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Kidney disease affects 30 million Americans. Adults with kidney disease have few treatment options. They can get dialysis, which removes harmful materials from the blood. Or, eligible patients may choose to get a kidney transplant. Patients who get a kidney transplant live longer and healthier lives compared with patients who receive dialysis. Getting a kidney from a person who is alive is a live donor kidney transplant, or LDKT. These transplants usually last much longer than a kidney from someone who has died. For this reason, doctors urge patients to find a living donor, such as a family member or friend. Patients usually get information about the benefits of LDKT from their kidney doctors at transplant clinics.

Although an LDKT is the best option for patients with kidney disease, black patients are much less likely than white patients to get one. Reasons for this difference may include unwillingness to talk to family members and friends about donation, mistrust, and difficulty finding eligible donors. Healthcare providers may not address concerns that black patients and families have about kidney transplants. This study is comparing three approaches to improve black patients’ chances of getting an LDKT.

Who can this research help?

Doctors and clinic administrators can use findings from the study when considering ways to help black patients who would benefit from an LDKT.

What is the research team doing?

The research team is examining whether adding peer mentors to a program called House Calls improves black patients’ chances of getting an LDKT. The research team previously created the House Calls program to help patients with kidney disease learn about kidney transplants. The program sends a health educator to patients’ homes to teach patients and their friends and families about LDKT.

Although patients who get house calls are more likely to get an LDKT, the program hasn’t worked as well with black patients. To improve the help and guidance that patients receive, patient advisors suggested matching patients with a peer mentor who received an LDKT. Peer mentors are people who have had kidney failure and gotten an LDKT. They provide support and guidance to others considering transplant.

In this study, the research team is enrolling 374 black patients approved for kidney transplant at two medical centers in Boston, Massachusetts, and Charleston, South Carolina. The team is assigning patients by chance to receive one of three approaches for educating patients about LDKT:

• Usual care: Patients get information about the benefits of LDKT from their kidney doctors, in the clinic.
• House calls and usual care: Patients get usual care plus a 90-minute information session from a health educator in the patient’s home, with family and friends present.
• House calls with peer mentorship and usual care: Patients get usual care, house calls, and emotional support and guidance from a peer mentor who received an LDKT for kidney failure.

The research team is tracking whether patients receive an LDKT within one year. The team is also looking at whether family or friends decide to be evaluated for donating a kidney. In addition, the team is asking about patients’ readiness to get an LDKT, concerns, quality of life, and knowledge about LDKT and other health topics.

Research methods at a glance