Does Sex, Race, and the Size of a Kidney Transplant Candidate's Social Network Affect the Number of Living Donor Requests? A Multicenter Social Network Analysis of Patients on the Kidney Transplant Waitlist.
Does Sex, Race, and the Size of a Kidney Transplant Candidate's Social Network Affect the Number of Living Donor Requests? A Multicenter Social Network Analysis of Patients on the Kidney Transplant Waitlist.
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DOI：
10.1097/tp.0000000000003167
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发表时间：
2020-12
期刊：
影响因子：
6.2
通讯作者：
Obradovic Z
中科院分区：
文献类型：
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作者：
Gillespie A;Gardiner HM;Fink EL;Reese PP;Gadegbeku CA;Obradovic Z
肾移植候选人的社交网络可以作为潜在的活体捐赠者的库。网络规模、网络强度和活体供肾请求的性别和种族差异可能导致活体供肾移植的差异。在这项多中心横断面研究中，我们通过对132名等待名单候选人（53%女性，69%黑人）的电话调查进行了以自我为中心的网络分析，以确定与请求活体肾脏捐赠相关的人口统计学和网络因素。女性参与者比男性参与者向更多的网络成员提出请求：发生率比（IRR）1.94，95%置信区间（CI）[1.23，3.07]，p < 0.01。黑人参与者倾向于比白人提出更多的请求（IRR 1.64，95% CI [1.00，2.71]，p = 0.05）。请求数量随着网络规模的增加而增加（IRR 1.09，95% CI [1.02，1.16]，p = 0.01）;然而，网络规模不因性别或种族而异。为候选人提供更多工具性支持的网络成员最有可能收到请求：比值比1.39，95% CI [1.08，1.78]，p = 0.01。移植候选人网络的规模和向成员提出的请求数量各不相同。以前观察到的种族和性别差异，在活体肾移植似乎不相关的网络规模或活体捐赠的要求，而是网络成员本身。未来的活体捐赠干预措施应侧重于网络成员，并根据他们与候选人的关系进行调整。
A kidney transplant candidate’s social network serves as a pool of potential living donors. Sex and racial differences in network size, network strength, and living donor requests may contribute to disparities in living donor kidney transplantation. In this multi-center cross-sectional study, we performed an egocentric network analysis via a telephone survey of 132 wait-listed candidates (53% female, 69% Black) to identify demographic and network factors associated with requesting living kidney donations. Female participants made requests to more network members than male participants: incidence rate ratio (IRR) 1.94, 95% confidence interval (CI) [1.23, 3.07], p < 0.01. Black participants tended to make more requests than whites (IRR 1.64, 95% CI [1.00, 2.71], p = 0.05). The number of requests increased with the size of the network (IRR 1.09, 95% CI [1.02, 1.16], p = 0.01); however, network size did not differ by sex or race. Network members who provided greater instrumental support to the candidates were most likely to receive a request: odds ratio 1.39, 95% CI [1.08,1.78], p = 0.01. Transplant candidates’ networks vary in size and in the number of requests made to the members. Previously observed racial and sex disparities in living donor kidney transplantation do not appear to be related to network size or to living donation requests, but rather to the network members themselves. Future living donor interventions should focus on the network members and be tailored to their relationship with the candidate.