Living donor kidney transplantation among ethnic minorities in the Netherlands: a model for breaking the hurdles

Patient Educ Couns. 2013 Jan;90(1):118-24. doi: 10.1016/j.pec.2012.08.004. Epub 2012 Aug 30.


Objective: Despite living donor kidney transplantation (LDKT) being the optimal treatment option for patients with end-stage renal disease, we observed a significant inequality in the number of LDKT performed between patients of Dutch versus non-Dutch descent. We conducted a focus group study to explore modifiable hurdles to LDKT.

Methods: Focus group discussions and in-depth interviews were conducted among 50 end-stage renal patients. Analyses were conducted according to 'grounded theory' using Atlas.ti.

Results: We found nearly all patients to be in favor of LDKT (96%). However, multiple factors played a role in considering LDKT. Four potentially modifiable hurdles were derived: (1) inadequate patient education, (2) impeding cognitions and emotions, (3) restrictive social influences, and (4) suboptimal communication. With regard to solutions, we found that our patients were open to home-based group education on renal replacement therapy options (88% in favor).

Conclusion: The study highlights the need for sensitivity and awareness of the influence of cultural factors on decision-making when discussing living donation with culturally diverse populations.

Practice implications: Since the majority of our patients were open to a tailored group education in their own homes, we see this as an opportunity to address factors that influence equality in access to LDKT.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude to Health*
  • Communication
  • Culture
  • Decision Making
  • Ethnicity / psychology*
  • Female
  • Focus Groups
  • Humans
  • Interviews as Topic
  • Kidney
  • Kidney Failure, Chronic / ethnology*
  • Kidney Failure, Chronic / psychology
  • Kidney Failure, Chronic / surgery
  • Kidney Transplantation / ethnology*
  • Kidney Transplantation / psychology
  • Living Donors*
  • Male
  • Middle Aged
  • Netherlands
  • Patient Education as Topic
  • Socioeconomic Factors
  • Tissue and Organ Procurement
  • Young Adult