abstract: 'There is ethnic inequity in access to living-donor kidney transplants in

  the UK. This study asked kidney patients from Black, Asian and minority

  ethnic groups why members of their family were not able to be living

  kidney donors. Responses were compared with responses from White

  individuals. This questionnaire-based mixed-methods study included

  adults transplanted between 1/4/13-31/3/17 at 14 UK hospitals.

  Participants were asked to indicate why relatives could not donate,

  selecting all options applicable from: Age; Health; Weight; Location;

  Financial/Cost; Job; Blood group; No-one to care for them after

  donation. A box entitled `Other-please give details'' was provided for

  free-text entries. Multivariable logistic regression was used to analyse

  the association between the likelihood of selecting each reason for

  non-donation and the participant''s self-reported ethnicity. Qualitative

  responses were analysed using inductive thematic analysis. In total,

  1240 questionnaires were returned (40\% response). There was strong

  evidence that Black, Asian and minority ethnic group individuals were

  more likely than White people to indicate that family members lived too

  far away to donate (adjusted odds ratio (aOR) = 3.25, 95\% Confidence

  Interval (CI) 2.30-4.58), were prevented from donating by financial

  concerns (aOR = 2.95, 95\% CI 2.02-4.29), were unable to take time off

  work (aOR = 1.88, 95\% CI 1.18-3.02), were ``not the right blood

  group{''''} (aOR = 1.65, 95\% CI 1.35-2.01), or had no-one to care for

  them post-donation (aOR = 3.73, 95\% CI 2.60-5.35). Four qualitative

  themes were identified from responses from Black, Asian and minority

  ethnic group participants: `Burden of disease within the family'';

  `Differing religious interpretations''; `Geographical concerns''; and `A

  culture of silence''. Patients perceive barriers to living kidney

  donation in the UK Black, Asian and minority ethnic population. If

  confirmed, these could be targeted by interventions to redress the

  observed ethnic inequity.'
affiliation: 'Wong, KT (Corresponding Author), Univ Bristol, Bristol Med Sch Populat
  Hlth Sci, Bristol BS8 2PS, Avon, England.

  Wong, KT (Corresponding Author), North Bristol NHS Trust, Southmead Hosp, Bristol
  BS10 5NB, Avon, England.

  Wong, Katie; Owen-Smith, Amanda; Caskey, Fergus; MacNeill, Stephanie; Ben-Shlomo,
  Yoav; Bailey, Pippa, Univ Bristol, Bristol Med Sch Populat Hlth Sci, Bristol BS8
  2PS, Avon, England.

  Wong, Katie; Caskey, Fergus; Bailey, Pippa, North Bristol NHS Trust, Southmead Hosp,
  Bristol BS10 5NB, Avon, England.

  Tomson, Charles R. V., Newcastle Upon Tyne Hosp NHS Fdn Trust, Newcastle Upon Tyne
  NE7 7DN, Tyne \& Wear, England.

  Dor, Frank J. M. F., Imperial Coll Healthcare NHS Trust, London W12 0HS, England.

  Bouacida, Soumeya, Bristol Hlth Partners Chron Kidney Dis Hlth Integ, Bristol BS1
  2NT, Avon, England.

  Idowu, Dela, Gift Living Donat GOLD, London NW10 0NS, England.'
article-number: '3751'
author: Wong, Katie and Owen-Smith, Amanda and Caskey, Fergus and MacNeill, Stephanie
  and Tomson, Charles R. V. and Dor, Frank J. M. F. and Ben-Shlomo, Yoav and Bouacida,
  Soumeya and Idowu, Dela and Bailey, Pippa
author-email: 'katie.wong@bristol.ac.uk

  a.owen-smith@bristol.ac.uk

  fergus.caskey@bristol.ac.uk

  stephanie.macneill@bristol.ac.uk

  ctomson@doctors.org.uk

  frank.dor@nhs.net

  pippa.bailey@bristol.ac.uk'
author_list:
- family: Wong
  given: Katie
- family: Owen-Smith
  given: Amanda
- family: Caskey
  given: Fergus
- family: MacNeill
  given: Stephanie
- family: Tomson
  given: Charles R. V.
- family: Dor
  given: Frank J. M. F.
- family: Ben-Shlomo
  given: Yoav
- family: Bouacida
  given: Soumeya
- family: Idowu
  given: Dela
- family: Bailey
  given: Pippa
da: '2023-09-28'
doi: 10.3390/jcm9113751
eissn: 2077-0383
files: []
journal: JOURNAL OF CLINICAL MEDICINE
keywords: 'living kidney donation; living-donor kidney transplantation; ethnic

  disparity'
keywords-plus: 'QUALITY-OF-LIFE; RENAL-TRANSPLANTATION; NETWORKS; BARRIERS; CRITERIA;

  RATES; RISK'
language: English
month: NOV
number: '11'
number-of-cited-references: '49'
orcid-numbers: 'Ben-Shlomo, Yoav/0000-0001-6648-3007

  Wong, Katie/0000-0002-9175-9236

  Bailey, Phillippa/0000-0003-2323-1082

  MacNeill, Stephanie/0000-0001-6553-1433

  Caskey, Fergus John/0000-0002-5199-3925

  Owen-Smith, Amanda/0000-0003-1188-2371'
papis_id: 387b934c91d6489f5a7a806c75930aac
ref: Wong2020investigatingethnic
researcherid-numbers: 'Ben-Shlomo, Yoav/ABD-2004-2021

  '
times-cited: '7'
title: 'Investigating Ethnic Disparity in Living-Donor Kidney Transplantation in the
  UK: Patient-Identified Reasons for Non-Donation among Family Members'
type: Article
unique-id: WOS:000593166800001
usage-count-last-180-days: '0'
usage-count-since-2013: '3'
volume: '9'
web-of-science-categories: Medicine, General \& Internal
year: '2020'