Frontiers in Pediatrics
Volume 7, Issue FEB, 2019

High rate of living kidney donation to immigrant children despite disparities-An epidemiological paradox? (Article) (Open Access)

Oztek-Celebi F.Z. , Herle M. , Ritschl V. , Kaltenegger L. , Stamm T. , Aufricht C. , Boehm M.*
  • a Department of Pediatrics and Adolescent Medicine, Dr. Sami Ulus Obstetrics and Gynecology and Pediatrics Training and Research Hospital, Ankara, Turkey
  • b Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
  • c Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
  • d Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
  • e Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
  • f Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria
  • g Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

Abstract

Background: Kidney transplantation is the preferred treatment modality for children with end-stage renal disease. In the adult population, migration-related modifiable factors were associated with low living donation rates; no such data are available on the pediatric population. This pilot study therefore compares donation modality, communication, knowledge, and attitudes/beliefs between families of immigrant and non-immigrant descent. Methods: Demographic and clinical characteristics of a cohort of children from 77 families of immigrant (32; 42%) and non-immigrant (45; 58%) descent who had undergone renal transplantation were assessed and related to donation modality at the Medical University of Vienna. In a representative subset, modifiable migration-related factors were assessed in a questionnaire-based study. Results: In immigrant families, information delay, limited communication, low knowledge levels, and self-reported conflicting beliefs were significantly more prevalent than in non-immigrants. The living kidney donation rate to children was high in both populations (immigrants: 63%, non-immigrants: 44%; p = 0.12). Living donation to children on dialysis was even significantly higher in immigrant families (immigrants: 13 out of 20; 57%, non-immigrants: 9 out of 33; 27%; p = 0.03). Conclusion: Contrary to expectations, migration-related disparities did not translate into decreased living donation rates in immigrant families, in particular to children on dialysis. Certain factors might therefore be less important for the living donation process in pediatric care structures and/or might be overcome by yet undefined protective factors. Larger pediatric studies including qualitative and quantitative methods are required to validate and refine current conceptual frameworks integrating the perspective of affected families. © 2019 Oztek-Celebi, Herle, Ritschl, Kaltenegger, Stamm, Aufricht and Boehm.

Author Keywords

Preemptive transplantation Donor source Pediatric renal replacement therapy Racial and ethnic disparities Immigration

Index Keywords

Nigeria immigrant end stage renal disease kidney donor living donor Jordan Thailand health disparity interpersonal communication human clinical assessment Self Report protection Turkey (republic) medical ethics Hungary organ donor Bulgaria tongue nephrologist male female patient referral pilot study Austrian Article major clinical study kidney graft migration Kidney Transplantation renal replacement therapy cohort analysis kidney disease parental attitude medical staff sex population migration Sudan
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85064395763&doi=10.3389%2ffped.2019.00025&partnerID=40&md5=f19d08c513b975c3817856bee967d06a
DOI: 10.3389/fped.2019.00025
ISSN: 22962360
Original Language: English