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Kidney Week

Abstract: PO2491

Implicit Bias in Recipient Selection

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Sweidan, Yousef, University Hospitals Cleveland Medical Center Department of Medicine, Cleveland, Ohio, United States
  • Mayuga, Christine, University Hospitals Cleveland Medical Center Department of Medicine, Cleveland, Ohio, United States
  • Chavin, Kenneth, University Hospitals Cleveland Medical Center Department of Surgery, Cleveland, Ohio, United States
  • Srinivas, Titte, University Hospitals Cleveland Medical Center Department of Medicine, Cleveland, Ohio, United States
  • Padiyar, Aparna, University Hospitals Cleveland Medical Center Department of Medicine, Cleveland, Ohio, United States
Background

The decision to place or exclude a candidate from the waitlist is not exclusively based on medical criteria. Scant literature exists regarding the intergroup dynamics within selection committees that influence decision making. This study attempts to clarify how the composition of selection committee meetings may affect listing outcome of kidney transplant candidates.

Methods

We performed a single-center retrospective study of kidney transplant selection committee attendance sheets and minutes from January 2012 to December 2015. We sought to determine if candidates who were evaluated by the same providers in attendance at selection committee are more likely to be listed for kidney transplant.

Results

3205 (48.4%) of 6630 donor and recipient candidates presented during 91 selection meetings from 2012 to 2015 were listed. 8 nephrologists, 9 surgeons and 3 social workers comprised the clinicians that both evaluated potential candidates and attended recipient selection meetings. Table 1 describes the frequency with which clinicians who were in attendance at selection meetings had previously evaluated the candidates being discussed.
Using binary logistic regression, the presence of the nephrologist or the surgeon who had evaluated the patient was significantly associated with a greater likelihood of the candidate being listed (OR 4.443 and 3.952 respectively, p=0.000, see Table 2). White race was also associated with an increased propensity to list, OR 1.202, p =0.006. Interestingly, the presence of both the nephrologist and surgeon who evaluated the patient, or the presence of both physicians and the social worker, were associated with reduced likelihood of listing (OR 0.267 for both, p=0.000 ; OR 0.715, p=0.001 for all three, see Table 2).

Conclusion

The composition of attendees at recipient selection meetings may influence listing outcomes of potential kidney transplant candidates.