Family matters, especially when it comes to African-Americans and living kidney donation. In a study conducted at Wake Forest Baptist Medical Center, researchers found that African-Americans donate almost exclusively to family members for living kidney transplants, as compared to Caucasians.
The retrospective study, published in the September/October online issue of the journal Clinical Transplantation, compared medical records of all former successful kidney donors at Wake Forest Baptist between Jan. 1, 1991, and Dec. 31, 2009. The purpose of the study was to characterize differences in donor and recipient relationships between African-American and Caucasian living kidney donors.
“African-Americans are overrepresented in the dialysis population and they are underrepresented among those who receive living donor kidney transplants, the best option for long-term treatment of kidney disease,” said Amber Reeves-Daniel, D.O., lead author of the study and medical director of the Living Kidney Donor Program at Wake Forest Baptist. “The more we can understand what contributes to people’s willingness to donate one of their kidneys, the better job we can do of educating potential living donors about the need and allay fears about the risks.”
The study sample consisted of 73 African-American and 324 Caucasian living kidney donors. African-American donors were more likely to be related to the transplant recipient than Caucasians. Individuals were considered to have a familial relationship if a blood relation existed or if there was a familial relationship, including in-law relationships.
In addition, the study found that African-American donors were more likely to donate to their parents compared to Caucasians, and were slightly less likely to participate in parent-to-child donation.
By comparison, Caucasian donors were more likely to be unrelated to the recipient than African-American donors.
Reeves-Daniel said one of the most surprising findings was that the majority of African- American kidney donors were men and younger than the white donors. “Adult African- American dialysis patients are typically younger than white dialysis patients and this may explain, in part, why African-American children are more often able to donate to their parents,” she said.
Future studies exploring cultural differences and family dynamics may provide targeted recruitment strategies for both African-American and Caucasian living kidney donors, Reeves-Daniel said. Unrelated living kidney transplantation appears to be a potential growth area for living kidney donation in African-Americans, she said.
Co-researchers on the study are: Dean Assimos, M.D., Carl Westcott, M.D., Jeffrey Rogers, M.D., Alan Farney, M.D., Ph.D., Robert Stratta, M.D., Barry Freedman, M.D., Asha Bailey, D.O., and Patricia Adams, M.D., Wake Forest Baptist Medical Center; Eric Hartmann, M.D., Piedmont Hospital; and Kurt Daniel, D.O., High Point Regional Medical Center.