• Nicole DePasquale, Matthew J Ellis, Debra L Sudan, Patti L Ephraim, Lisa M McElroy, Dinushika Mohottige, Clemontina A Davenport, Xiyuan Zhang, Sarah B Peskoe, Tara S Strigo, Ashley N Cabacungan, Iris Pounds, Jennie A Riley, Margaret Falkovic, and L Ebony Boulware.
• Division of General Internal Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
• Clin Transplant. 2021 Apr 1; 35 (4): e14222.

BackgroundAlthough discussions with family or friends can improve access to living-donor kidney transplantation (LDKT), they remain an understudied step in the LDKT process.MethodsAmong 300 African American transplant candidates, we examined how sociodemographic, clinical, LDKT-related, and psychosocial characteristics related to the occurrence of LDKT discussions with family or friends. We also analyzed the relation between discussion occurrence and donor activation on transplant candidates' behalves (at least one donor inquiry or completed donor evaluation in the medical record). We assessed associations of discussion characteristics (context, content, and perceptions) with donor activation among discussants, and we identified discussion barriers among non-discussants.ResultsMost candidates (90%) had discussed LDKT. Only family functioning was statistically significantly associated with discussion occurrence. Specifically, family dysfunction was associated with 62% lower odds of discussion than family function. Family functioning, discussion occurrence, and different discussion characteristics were statistically significantly related to donor activation. The most prevalent discussion barrier was never having thought about discussing LDKT.ConclusionsFamily functioning affected the likelihood of discussing LDKT, and family functioning, discussion occurrence, and discussion characteristics were associated with donor activation. Advancing understanding of how family functioning and LDKT discussions affect progression to LDKT may benefit interventions to increase LDKT.© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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