The Southeastern Kidney Transplant (SEKTx) Coalition is an academic-community collaboration between partners in the kidney disease community who share the common goal of eliminating health disparities in access to kidney transplantation among African American End Stage Renal Disease (ESRD) living in Georgia, North Carolina, and South Carolina. Volunteer members of this community-based coalition include ESRD and transplant patients, dialysis facility staff and providers, transplant centers, quality improvement organizations, and patient advocacy organizations. The burden of CKD and ESRD is highest in the Southeast, and yet the rate of kidney transplantation is the lowest in the nation. Further, our research suggests that racial disparities in access to transplant are concentrated in the Southeast, where African Americans (AA) are less likely to access each step in the transplant process. In 2014, our SEKTx Coalition conducted a randomized, multicomponent intervention (Reducing Disparities In Access to kidNey Transplantation [RaDIANT]) Community Study in GA, the state with the lowest kidney transplant rates in the nation, consisting of patient- and provider-focused educational and engagement interventions designed to increase referral for transplant evaluation among AA ESRD patients. This study was effective in improving referral for kidney transplantation among AA in GA, but efforts to improve access to kidney transplantation must be expanded beyond GA and should include interventions targeting steps beyond referral to the medical evaluation at the transplant center. The long-term goal of the SEKTx Coalition is to eliminate racial disparities in every step of the kidney transplant process.
Our Specific Aims are:
Specific Aim 1. Determine reasons for racial disparities in medical evaluation for kidney transplantation among dialysis patients in GA, NC and SC.
Specific Aim 2 : Implement the RaDIANT Regional Study in GA, NC, and SC with the goal of increasing rates of referral, medical evaluation, and waitlisting, and reducing disparities in these key steps.
Specific Aim 3 : Conduct a process and outcome evaluation of the RaDIANT Regional Study interventions. The overall impact of this proposal is to improve transplant access among the AA ESRD population in the Southeast and reduce health disparities in transplantation.

Public Health Relevance

The burden of kidney disease is highest in the Southeast, and yet the rate of kidney transplantation is the lowest in the nation. The proposed study seeks to leverage an existing academic-community collaboration with the Southeastern Kidney Transplant Coalition to evaluate the effectiveness of a multilevel intervention targeting End Stage Renal Disease patients and dialysis facility staff in reducing racial disparities in access t kidney transplantation.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZMD1)
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Berzon, Richard
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Emory University
Schools of Medicine
United States
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Gander, Jennifer C; Zhang, Xingyu; Plantinga, Laura et al. (2018) Racial disparities in preemptive referral for kidney transplantation in Georgia. Clin Transplant 32:e13380
Gander, Jennifer C; Basu, Mohua; McPherson, Laura et al. (2018) iChoose Kidney for Treatment Options: Updated Models for Shared Decision Aid. Transplantation 102:e370-e371
Lipford, Kristie J; McPherson, Laura; Hamoda, Reem et al. (2018) Dialysis facility staff perceptions of racial, gender, and age disparities in access to renal transplantation. BMC Nephrol 19:5
Patzer, Rachel E; McPherson, Laura; Basu, Mohua et al. (2018) Effect of the iChoose Kidney decision aid in improving knowledge about treatment options among transplant candidates: A randomized controlled trial. Am J Transplant 18:1954-1965
Paul, Sudeshna; Plantinga, Laura C; Pastan, Stephen O et al. (2018) Standardized Transplantation Referral Ratio to Assess Performance of Transplant Referral among Dialysis Facilities. Clin J Am Soc Nephrol 13:282-289
Hamoda, Reem E; Gander, Jennifer C; McPherson, Laura J et al. (2018) Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation. BMC Nephrol 19:13
McPherson, Laura J; Hamoda, Reem E; Patzer, Rachel E (2018) Measuring Patient Knowledge of Kidney Transplantation: an Initial Step to Close the Knowledge Gap. Transplantation :
Gander, Jennifer C; Gordon, Elisa J; Patzer, Rachel E (2017) Decision aids to increase living donor kidney transplantation. Curr Transplant Rep 4:1-12
Patzer, Rachel E; Paul, Sudeshna; Plantinga, Laura et al. (2017) A Randomized Trial to Reduce Disparities in Referral for Transplant Evaluation. J Am Soc Nephrol 28:935-942
Plantinga, Laura C; Pastan, Stephen O; Wilk, Adam S et al. (2017) Referral for Kidney Transplantation and Indicators of Quality of Dialysis Care: A Cross-sectional Study. Am J Kidney Dis 69:257-265

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