Patient Networks Promote Living Donor Transplantation Conversations

New Orleans—Ideas, attitudes, and behaviors are known to spread within social networks; however, there are few available data on the structure and influence of social networks within the framework of hemodialysis clinics. Avrum Gillespie, MD, and colleagues utilized a survey and observational data to examine the role of patient hemodialysis social networks and discussions of living donor kidney transplantation. Results of the study were reported during a poster session at Kidney Week 2017 in a poster titled Hemodialysis Patient Social Networks Promote Living Donor Transplant Discussions.

The survey was administered to 46 hemodialysis patients between August 2012 and February 2015 to characterize the social network in a newly opened clinic. Mean age of participants was 54 years, 58% were male, 39% were Hispanic, 30% were African American, and 65% had discusses transplant with the clinic nephrologist.

Of the 46 patients surveyed, 70% (n=32) had interacted with others to form a social network; 44% reported they had discussed transplantation with other patients. Patients who discussed transplantation with other patients in the clinic were 19 times more likely to request family and friends to consider living donation compared with those who were not connected to other patients through the clinic network (odds ratio [OR], 18.7; 95% confidence interval [CI], 3.4-101.5; P=.001).

Patients who reported discussing transplant with hemodialysis staff were also more likely to discuss the possibility of transplantation compared with patients who did not discuss the option (OR, 5.1; 95% CI, 1.5-18.1; P=.01). There was no association between patient characteristics and discussions with living donation with individuals outside the clinic setting.

In conclusion, the researchers said, “This study found that patients who discuss transplant with other patients and staff in the hemodialysis unit are more likely to request consideration of living donation from members of their extra-clinic networks. These findings suggest hemodialysis patient networks are potential targets for social network interventions. This research also challenges the current ecological approach to barriers to transplantation, which attributes only a small role to the hemodialysis clinic and often neglects the role of patient interactions.”

Source: Gillespie A, Rao S, Dawson SE. Hemodialysis patient social networks promote living donor transplant discussions. Abstract of a poster presented at the American Society of Nephrology 2017 Kidney Week, November 2, 2017, New Orleans, Louisiana.