Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study

Introduction: Both immigrant and racialized status may be associated with the pursuit of living donor kidney transplant (LDKT). Methods: This study was a secondary analysis of a convenience cross-sectional sample of patients with kidney failure in Toronto, obtained from our “Comprehensive Psychosoci...

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Main Authors: Eric Lui, Jasleen Gill, Marzan Hamid, Cindy Wen, Navneet Singh, Princess Okoh, Xihui Xu, Priscilla Boakye, Carl E. James, Amy D. Waterman, Beth Edwards, Istvan Mucsi
Format: Article
Language:English
Published: Elsevier 2024-04-01
Series:Kidney International Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2468024924000561
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author Eric Lui
Jasleen Gill
Marzan Hamid
Cindy Wen
Navneet Singh
Princess Okoh
Xihui Xu
Priscilla Boakye
Carl E. James
Amy D. Waterman
Beth Edwards
Istvan Mucsi
author_facet Eric Lui
Jasleen Gill
Marzan Hamid
Cindy Wen
Navneet Singh
Princess Okoh
Xihui Xu
Priscilla Boakye
Carl E. James
Amy D. Waterman
Beth Edwards
Istvan Mucsi
author_sort Eric Lui
collection DOAJ
description Introduction: Both immigrant and racialized status may be associated with the pursuit of living donor kidney transplant (LDKT). Methods: This study was a secondary analysis of a convenience cross-sectional sample of patients with kidney failure in Toronto, obtained from our “Comprehensive Psychosocial Research Data System” research database. The exposures included racialized, immigrant, and combined immigrant and racialized status (White nonimmigrant, racialized nonimmigrant, White immigrant and racialized immigrant). Outcomes include the following: (i) having spoken about LDKT with others, (ii) having a potential living donor (LD) identified, (iii) having allowed others to share the need for LDKT, (iv) having directly asked a potential donor to be tested, and (v) accept a hypothetical LDKT offer. We assessed the association between exposure and outcomes using univariable, and multivariable binary or multinominal logistic regression (reference: White or White nonimmigrant participants). Results: Of the 498 participants, 281 (56%) were immigrants; 142 (28%) were African, Caribbean, and Black (ACB); 123 (25%) were Asian; and 233 (47%) were White. Compared to White nonimmigrants, racialized immigrants (relative risk ratio [RRR]: 2.98; 95% confidence interval [CI]: 1.76–5.03) and racialized nonimmigrants (RRR: 2.84; 95% CI: 1.22–6.65) were more likely not to have spoken about LDKT with others (vs. having spoken or planning to do so). Both racialized immigrant (odds ratio [OR]: 4.07; 95% CI: 2.50–6.34), racialized nonimmigrants (OR: 2.68; 95% CI: 1.31–5.51) and White immigrants (OR: 2.68; 95% CI: 1.43–5.05) were more likely not to have a potential LD identified. Conclusion: Both racialized and immigrant status are associated with less readiness to pursue LDKT. Supporting patients to communicate their need for LDKT may improve equitable access to LDKT.
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spelling doaj-art-607844504dbb4f40b1e90b78f296dc712025-08-20T02:31:47ZengElsevierKidney International Reports2468-02492024-04-019496097210.1016/j.ekir.2024.01.044Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort StudyEric Lui0Jasleen Gill1Marzan Hamid2Cindy Wen3Navneet Singh4Princess Okoh5Xihui Xu6Priscilla Boakye7Carl E. James8Amy D. Waterman9Beth Edwards10Istvan Mucsi11Ajmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, CanadaAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, CanadaAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, Canada; Stanford University School of Medicine, Stanford, California, USAAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, CanadaAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, CanadaAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, CanadaAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, CanadaDaphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, CanadaFaculty of Education, York University, Toronto, Ontario, CanadaDepartment of Surgery and J.C. Walter Jr. Transplant Center, Houston Methodist Hospital, Houston, Texas, USAAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, CanadaAjmera Transplant Center and Division of Nephrology Department, University Health Network, University of Toronto, Toronto, Ontario, Canada; Correspondence: Istvan Mucsi, Ajmera Transplant Center, 585 University Avenue, MARS Building, Floor 9, Room 9062, Toronto, Ontario M5N 2N2, Canada.Introduction: Both immigrant and racialized status may be associated with the pursuit of living donor kidney transplant (LDKT). Methods: This study was a secondary analysis of a convenience cross-sectional sample of patients with kidney failure in Toronto, obtained from our “Comprehensive Psychosocial Research Data System” research database. The exposures included racialized, immigrant, and combined immigrant and racialized status (White nonimmigrant, racialized nonimmigrant, White immigrant and racialized immigrant). Outcomes include the following: (i) having spoken about LDKT with others, (ii) having a potential living donor (LD) identified, (iii) having allowed others to share the need for LDKT, (iv) having directly asked a potential donor to be tested, and (v) accept a hypothetical LDKT offer. We assessed the association between exposure and outcomes using univariable, and multivariable binary or multinominal logistic regression (reference: White or White nonimmigrant participants). Results: Of the 498 participants, 281 (56%) were immigrants; 142 (28%) were African, Caribbean, and Black (ACB); 123 (25%) were Asian; and 233 (47%) were White. Compared to White nonimmigrants, racialized immigrants (relative risk ratio [RRR]: 2.98; 95% confidence interval [CI]: 1.76–5.03) and racialized nonimmigrants (RRR: 2.84; 95% CI: 1.22–6.65) were more likely not to have spoken about LDKT with others (vs. having spoken or planning to do so). Both racialized immigrant (odds ratio [OR]: 4.07; 95% CI: 2.50–6.34), racialized nonimmigrants (OR: 2.68; 95% CI: 1.31–5.51) and White immigrants (OR: 2.68; 95% CI: 1.43–5.05) were more likely not to have a potential LD identified. Conclusion: Both racialized and immigrant status are associated with less readiness to pursue LDKT. Supporting patients to communicate their need for LDKT may improve equitable access to LDKT.http://www.sciencedirect.com/science/article/pii/S2468024924000561immigrantlive donor kidney transplanttransplant
spellingShingle Eric Lui
Jasleen Gill
Marzan Hamid
Cindy Wen
Navneet Singh
Princess Okoh
Xihui Xu
Priscilla Boakye
Carl E. James
Amy D. Waterman
Beth Edwards
Istvan Mucsi
Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study
Kidney International Reports
immigrant
live donor kidney transplant
transplant
title Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study
title_full Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study
title_fullStr Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study
title_full_unstemmed Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study
title_short Racialized and Immigrant Status and the Pursuit of Living Donor Kidney Transplant - a Canadian Cohort Study
title_sort racialized and immigrant status and the pursuit of living donor kidney transplant a canadian cohort study
topic immigrant
live donor kidney transplant
transplant
url http://www.sciencedirect.com/science/article/pii/S2468024924000561
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