title: Can family attributes explain the racial disparity in living kidney donation?
abstract: BACKGROUND
  Living donation is a safe, effective treatment for patients with end-stage renal disease (ESRD), yet rates of live kidney donation remain low. Potential transplant recipients may be more inclined to ask a family member for a living donation if they feel familial closeness.
  
  
  METHODS
  The FACES II and the Living Organ Donor Survey were administered to patients attending pretransplant education to assess individual perceptions of family structure and willingness to request a living kidney donation from a family member.
  
  
  RESULTS
  A total of 328 potential transplant recipients were included in the study: 200 (61%) African American and 128 (39%) Caucasian. Approximately half were willing to ask for a living donation. Individual's perception of family cohesion, adaptability, and type as measured by FACES II showed most families were mid-range with optimal cohesion and adaptability. Family cohesion and adaptability showed no association with being willing to request a live donation, but those single/never married were only half as likely to ask for donation (odds Ratio [OR] 0.51; 95% confidence interval [CI] 0.31-0.86, P = .01). Lower education (beta = -0.49) and unmarried status (beta = -0.31) predicted a lower cohesion score.
  
  
  CONCLUSIONS
  Family type, cohesion, and adaptability showed no differences across race and was not related to the potential recipient's willingness to ask for a live donation. Although responses by race did not differ, an important finding showed that only half of ESRD patients are willing to ask for a live organ donation, and those patients that were single/never married were less likely to ask for a living donation. Research surrounding this reluctance is warranted.
authors.affiliation: Division of Transplant Surgery, Department of Surgery, College of Medicine, Medical University of South Carolina, 1512 Rutledge Avenue, Charleston, SC 29412, USA. lunsfos@musc.edu
authors.forename: S L
authors.initials: SL
authors.lastname: Lunsford
authors.forename: K S
authors.initials: KS
authors.lastname: Simpson
authors.forename: K D
authors.initials: KD
authors.lastname: Chavin
authors.forename: K J
authors.initials: KJ
authors.lastname: Mensching
authors.forename: L G
authors.initials: LG
authors.lastname: Miles
authors.forename: L M
authors.initials: LM
authors.lastname: Shilling
authors.forename: G R
authors.initials: GR
authors.lastname: Smalls
authors.forename: P K
authors.initials: PK
authors.lastname: Baliga
mesh_terms: D044383:Black People / Q000706:statistics & numerical data; D005190:Family; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007668:Kidney; D007676:Kidney Failure, Chronic / Q000523:psychology / Q000601:surgery; D019520:Living Donors / Q000523:psychology / Q000706:statistics & numerical data*; D008297:Male; D010146:Pain; D044469:Racial Groups; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American