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Abstract: TH-PO1167

Financial Strain and Pursuit of Live Donor Kidney Transplants Among African Americans on the Kidney Transplant Waiting List

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Cabacungan, Ashley N., Duke University, Durham, North Carolina, United States
  • Ellis, Matthew Jay, Duke University, Durham, North Carolina, United States
  • Sudan, Debra, Duke University Medical Center, Durham, North Carolina, United States
  • Davenport, Clemontina A., Duke University, Durham, North Carolina, United States
  • Ephraim, Patti, Johns Hopkins University, Baltimore, Maryland, United States
  • Strigo, Tara Smith, Duke University, Durham, North Carolina, United States
  • Pounds, Iris, Duke University, Durham, North Carolina, United States
  • Alkon, Aviel N., Duke University, Durham, North Carolina, United States
  • Mohottige, Dinushika, Duke University, Durham, North Carolina, United States
  • DePasquale, Nicole, Duke University, Durham, North Carolina, United States
  • Peskoe, Sarah B., Duke University, Durham, North Carolina, United States
  • Pendergast, Jane F., Duke University, Durham, North Carolina, United States
  • Diamantidis, Clarissa Jonas, Duke University, Durham, North Carolina, United States
  • St. Clair Russell, Jennifer, National Kidney Foundation, Washington, District of Columbia, United States
  • Boulware, L. Ebony, Duke University School of Medicine, Durham, North Carolina, United States
Background

The extent to which financial strain may influence African American’s (AAs) pursuit of LDKT is unclear.

Methods

We studied cross-sectional associations between financial strain and LDKT activation or live donor inquiries to the transplant center among AAs on the kidney transplant waiting list. We measured financial strain using the InCharge Financial Distress/Financial Well-being 8-item Scale (IFDFWS-- responses ranging from 1 (high) to 10 (low/no) distress). We measured LDKT activation as participants’ self-reported behaviors reflecting low (no family/friends LDKT discussion, no donor identified), moderate (family/friends LDKT discussion, no donor identified) or high (family/friends LDKT discussion and donor identified) activation. In logistic regression models, we quantified the association between financial strain and LDKT activation or inquiries.

Results

Among 300 participants, the median time on the wait list was 292 (IQR 81, 700) days. The mean age was 52 (SD 11), 56% were male, 50% were retired due to disability, 43% had household income < $40,000 and 25% were near or below poverty. The mean (SD) IFDFWS score was 6.2 (2), indicating moderate financial distress. Subscale mean (SD) scores were: 4.7 (2.8) for current and 4.7 (2.8) general financial stress; 4.5 (2.9) for financial concern, 5.4 (2.7) satisfaction and 5.6 (2.6) comfort, 6 (3.2) for confidence to obtain emergency funds, 5.2 (3.3) for paycheck-to-paycheck living and 3.5 (2.7) for ability to afford recreational activities. Overall financial distress was not associated with LDKT activation (OR: 1.04, 95% CI 0.91, 1.19) or donor inquiries (OR: 1.08, 95% CI 0.95, 1.22). However, participants with greater (versus less) confidence in obtaining emergency funds had statistically significantly greater odds of having a donor inquiry (OR: 1.14, 95% CI 1.04, 1.24).

Conclusion

Financial confidence may be associated with access to LDKT, including the receipt of live donor inquiries. The impact of financial strain on pursuit of LDKT among African American transplant candidates requires further study.

Funding

  • NIDDK Support