title: Information channels and the dynamics of uptake of living kidney donors: a retrospective study in a reference area.
abstract: BACKGROUND
  Activity in renal transplantation at our center continues to grow due to the gradual increase in living donor kidney transplantations (LDKT). Our objective was to describe the generation process of living donation in our area of influence including two provinces and 18 chronic kidney disease (CKD) treatment units in particular the origin of paired donor/recipients and information channels.
  
  
  METHODS
  We included all actual and discarded potential donors from 2005 to 2009. History and telephone interviews provided a description of the cases, sources and process information.
  
  
  RESULTS
  Among 95 potential pairs we performed 44 LDKT during this period. The recipients were predialysis (38%), on dialysis (54%), or after prior transplantation (8%). Among the 10 dialysis centers, the referral rate ranged between 0 and 8.6 pairs per 100 patients. We contacted 78 (83%) donors for an interview, among whom 53% first learned of LDKT when the recipient already had advanced CKD at predialysis or dialysis stages. Television was the main means of this first knowledge (38%), followed by the health care staff. LDKT was not primarily a treatment option offered by the nephrologist for 65% of subjects; however, the nephrologists were the major reference sources followed by the Internet and transplant coordinators.
  
  
  CONCLUSIONS
  The majority of donations are initiated before the recipient is on dialysis, but eventuates predialysis in only 38% of cases. The possibility of being referred seems to be influenced by the recipient's treatment center. We need a more proactive role of nephrologists to offer this therapeutic option. This study identified the importance of public information to identify targets and design strategies to disseminate quality information on LDKT.
authors.affiliation: Unidad de Gestión Clinica de Urologia y Nefrologia, Hospital Universitario Virgen del Rocio, Sevilla, Spain. marisavidalblandino@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Vidal Blandino
authors.forename: M A
authors.initials: MA
authors.lastname: Gentil Govantes
authors.forename: V
authors.initials: V
authors.lastname: Cabello Chaves
authors.forename: P
authors.initials: P
authors.lastname: Pereira Palomo
authors.forename: G
authors.initials: G
authors.lastname: Bernal Blanco
authors.forename: F M
authors.initials: FM
authors.lastname: Gonzalez Roncero
authors.forename: J
authors.initials: J
authors.lastname: Fijo Viota
authors.forename: R
authors.initials: R
authors.lastname: Medina López
mesh_terms: D022126:Access to Information; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033181:Information Dissemination; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D019520:Living Donors / Q000600:supply & distribution*; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012017:Referral and Consultation; D012189:Retrospective Studies; D013030:Spain; D013690:Television; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*