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Minority Affairs Committee Update

Minority Affairs Committee Update . March 13, 2012 Meeting Chicago O’Hare Hilton. Minority Affairs Committee Update. Educational Guidelines on Patient Referral to Kidney Transplantation Disparities in Presentation of Transplant Information Ongoing CPRA Analysis

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Minority Affairs Committee Update

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  1. Minority Affairs Committee Update March 13, 2012 Meeting Chicago O’Hare Hilton

  2. Minority Affairs Committee Update • Educational Guidelines on Patient Referral to Kidney Transplantation • Disparities in Presentation of Transplant Information • Ongoing CPRA Analysis • Update on New Proposed MAC Projects

  3. Educational Guidelines on Patient Referral to Kidney Transplantation • MAC Subcommittee formed to develop educational guidelines for providers regarding appropriate patient referral. • Draft guidelines document has been approved by the Subcommittee and full Committee. • Additional review by Kidney, Patient Affairs, Living Donor and Transplant Administrators Committee as well as professional transplant partner s (NKF, AST, ASTS, KDOQUI, AMAT, NTSW, etc.) will occur as part of an expanded Subcommittee.

  4. Disparities in Provision of Transplant Information • Many patients uninformed of kidney transplant options at time of 2728 filing. • Most common reason reported: patient not assessed at filing time. • Factors influencing likelihood of referral: • profit/non profit status of dialysis center • age, gender, ethnicity • obesity • insurance status (private vs. public) • under the care of a nephrologist prior to ESRD

  5. Evaluation of Calculated PRA (CPRA) Policy for Allocation of Deceased Donor Kidneys: Transplant Rates by Ethnicity and Sensitization Level

  6. Adult Kidney Registrations as of 2/10/12 • 38% White, 34% Black, 18% Hispanic, 7% Asian and 2% other ethnicities. • 16% -- CPRA value of 80-100%. • 9.8% waiting with current CPRA ≥ 98%, and of these, 43% were Black, 35% White, 14% Hispanic, 6% Asian, and 2% other ethnicities.

  7. TX Rate Changes Post Policy Implementation • Significant decrease for non-sensitized (CPRA 0%) and low sensitized CPRA 1-20%) White, Black, and Hispanic candidates • Significant increase for White, Black, and Asian moderately sensitized (CPRA 21-79%) candidates • No significant change among American Indian/Alaska Native, Native Hawaiian/Other Pacific Islander, or Multiracial candidates, regardless of sensitization level.

  8. Changes in TX Rates • Significant increase for highly sensitized (CPRA 80-100%) White, Black, and Hispanic candidates • Significant increase among White, Black, and Hispanic candidates with a CPRA of 80-97%, but decrease (although not significant) in transplant rates for those with CPRA of 98-100%. • This was also true for Asian candidates, although the decrease in transplant rates for those candidates with CPRA ≥ 98% was significant.

  9. Eligible Donor Conversion RatesBy Region and Ethnicity

  10. Eligible Donor Conversion Rates, 2/1/08-11/30/11by Year: All Regions 10

  11. Eligible Donor Conversion Rates, 2/1/08-11/30/11by Donor Ethnicity: All Regions 11

  12. Eligible Donor Conversion Rates, 2/1/08-11/30/11by Year and Ethnicity: All Regions 12

  13. Results • Across all regions and donor ethnicities the donor conversion rate was 70.1% and it ranged from 67% in 2008 to 73% in 2011. • Overall conversion rate was the highest among donors of multiracial ethnicity (85%), followed by White donors (78%), Hispanics (67%), Blacks (55%), Asians (48%), Native Hawaiians/other Pacific Islanders (46%), and American Indians/Alaska Natives (40%).

  14. Results • Within each region, eligible donor conversion rates varied among donor ethnic groups. • Regions 4 and 6 seemed to have increasing conversion rates across different donor ethnic groups during 2008-2011.

  15. Update on New Proposed Committee Projects • Referral Survey to Assess Barriers to Thoracic Transplantation • Minority Donor Conversion Rates

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