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Abstract: FR-PO884

Incarceration of Black ESKD Patients' Family Members as a Barrier to Living Kidney Donation

Session Information

Category: Diversity and Equity in Kidney Health

  • 800 Diversity and Equity in Kidney Health

Authors

  • Gillespie, Avrum, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
  • Daw, Jonathan, The Pennsylvania State University - University Park Campus, University Park, Pennsylvania, United States
  • Corradi, Andrea, Georgia Southern University, Statesboro, Georgia, United States
  • Lee, Briana Eugene, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
  • Calvelli, Hannah, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
  • Quinn, Sally Boyle, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
  • Pfeffer, Zoe, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, United States
  • Gardiner, Heather Marie, Temple University College of Public Health, Philadelphia, Pennsylvania, United States
  • Fink, Edward L., Temple University College of Liberal Arts, Philadelphia, Pennsylvania, United States
  • Gadegbeku, Crystal A., Cleveland Clinic, Cleveland, Ohio, United States
  • Reese, Peter P., University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Obradovic, Zoran, Temple University, Philadelphia, Pennsylvania, United States
Background

There are racial disparities in living donor kidney transplantation (LDKT) between Black and White Americans. Few studies have examined how systemic racism has contributed to these disparities. Punitive policies leading to mass incarceration have disproportionately affected Black Americans and are a large contributor to systemic racism in the U.S. In this study, we examine whether the disproportionate impact of mass incarceration may be contributing to racial disparities in LDKT by preventing access to potential living donors because of the incarceration of Black ESKD patients' family members.

Methods

This is a cross-sectional interviewer-administered social network survey of prevalent hemodialysis patients as part of a living donor communication intervention conducted in an urban dialysis clinic in the Middle Atlantic region. Participants were asked, “Have any members of your immediate family, NOT including yourself, ever been held in jail or prison for one night or longer?”, and the number of family members affected by incarceration. Participants were then asked how many members affected by incarceration could have potentially donated. Chi square and Fisher’s exact tests were used to test the statistical significance of the independent variables’ association with categorical dependent variables, and a t test was used for dependent continuous variables.

Results

Between February to March 2022, 23 transplant eligible self-identified Black and Mixed Race ESKD patients participated in the survey. Participant demographics included a mean age of 55 ± 9 years, 65% were female, and 75% had a household income less than $40,000. 52% of participants reported having a family member incarcerated, with most having 2-3 members. Participants reported that greater than 75% of the family members who were affected by incarceration could have potentially donated. There were no significant differences in family member incarceration and demographic variables.

Conclusion

Of the patients surveyed, 39% had at least one incarcerated family member in prison who could have potentially donated if they were not incarcerated. Identifying how systemic racism affects health disparities is the first step to ensuring health equity in kidney transplantation.

Funding

  • NIDDK Support