Addressing Disparities in Transplant Access among Spanish-Speaking Patients

NKF Spring Clinical Meetings 2021

Compared with non-Hispanic White Americans, Hispanic Americans receive disproportionally fewer organ transplants. In 2018, the Hispanic Transplant Clinic was established at the University of Colorado. Madhura Pande and colleagues at the University of Colorado School of Medicine, Aurora, conducted a study to examine the efficacy of the program in reducing this disparity.

The researchers reported results of the analysis during a virtual poster session at the NKF Spring Clinical Meetings. The poster was titled Reducing Transplant Disparities for Spanish-Speaking Patients.

The researchers performed a mixed-methods analysis of data from 406 Spanish-speaking patients who were referred for transplant to the University of Colorado Hospital between 2015 and 2019. Outcomes for patients referred between 2015-2017 were compared with outcomes for patients referred between 2018-2019. Semi-structured telephone interviews were conducted with six patients per time period, as well as with nephrology providers in the Denver, Colorado metro area. Interviewees were asked to evaluate communication, transplant education, and overall experience.

In comparisons of averages of the two time periods, there was a percentage increase in the number of patients completing each step of the transplant process during 2018-2019: 74.9% increase in referrals; 87.9% increase in evaluations; 137.5% increase in committee reviews; 38.4% increase in listings; and 11.1% increase in transplants.

In the interviews of patients in the 2018-2019 time period, all patients expressed understanding of the process of kidney transplantation and described the Spanish-speaking providers as thorough. Conversely, patients evaluated prior to 2018 described issues with communications, reporting difficulty understanding their status in the transplant process.

Overall, the nephrologists reported a positive experience with the Hispanic Transplant Clinic. They all indicated it was easier to refer their Spanish-speaking patients and that more patients were undergoing evaluation for kidney transplant.

In conclusion, the researchers said, “The establishment of the Hispanic Transplant Clinic is associated with increased numbers of Hispanic patients per year completing steps of the transplant process. This supports establishing clinics oriented to Spanish-speaking patients as a means of reducing transplant disparities for Hispanic Americans.”

Source: Pande M, Grafals M, Rizzolo K, Kenrick J. Reducing transplant disparities for Spanish-speaking patients. Abstract of a poster presented at the National Kidney Foundation virtual Spring Clinical Meetings 2021 (Abstract #373), April 9, 2021.