Attitudes towards Living Donor Kidney Transplantation among Urban African American Hemodialysis Patients: A Qualitative and Quantitative Analysis

While living donor kidney transplantation (LDKT) is the treatment of choice for end-stage renal disease patients (ESRD), the potential barriers to LDKT are not well understood, especially among African American patients who have higher rates of ESRD but lower LDKT than Whites. To address this gap, a cross-sectional survey (n=101) identified LDKT experiences and attitudes among urban African American adults receiving hemodialysis at two outpatient clinics in Philadelphia. Most patients (72.3%) were interested in LDKT but only 34.2% had asked someone for a donation. Concerns about the donor (33.3%), asking for a kidney (28.1%), and their own health (24.6%) were major barriers. Patients also expressed guilt (56.3%) and fear (37.2%). About half (49.5%) had an unsolicited offer, regardless of whether or not they asked. The survey results suggest that interventions should focus on overcoming reluctance to ask for a kidney donation or to accept unsolicited offers.