# Reducing disparities in living donor transplant among African Americans

> **NIH NIH R01** · EMORY UNIVERSITY · 2020 · $231,134

## Abstract

Abstract
For most of the patients in the United States with end stage renal disease (ESRD), kidney transplantation
represents the optimal treatment. Moreover, living donor kidney transplantation (LDKT) offers numerous
advantages over deceased donor kidney transplant such as better kidney quality, increased short- and long-
term graft survival, lower rates of acute rejection, and reduced health care cost. Nevertheless, there are
pervasive racial disparities in access to LDKT, with white ESRD patients four times more likely to receive a
LDKT than African American ESRD patients. The long-term objective of this program of research is to
understand the combined effect of a systems-level intervention that enhances communication between dialysis
facility and transplant center clinicians (Transplant Referral EXchange or T-REX) and a culturally-sensitive
individual-level educational intervention (web-based Living ACTS: About Choices in Transplantation and
Sharing) on racial disparities in access to LDKT. The specific aims of the study are: (a) To develop and refine
a web-based version of Living ACTS; (b) To conduct an outcome evaluation of the newly created web-based
Living ACTS intervention by comparing the percent of patients with at least one inquiry from a potential living
donor among patients who receive Living ACTS compared to those who receive a control website with an
embedded educational video; and (c) To conduct a process evaluation of the newly created web-based Living
ACTS intervention by adapting commonly used process evaluation constructs (context, reach, dose received,
fidelity, and recruitment) for an online environment.
We will conduct a randomized controlled trial among a sample of 800 African American ESRD patients in the
southeastern United States (ESRD Network 6 in Georgia and South Carolina), the region of the country with
the largest proportion of African American ESRD patients on the waiting list. Patients will be randomly
assigned to one of two study conditions (intervention or control). Participants at all four collaborating transplant
centers will be seen by providers who utilize T-REX, thus allowing us to test the independent effect of
individual-level education on a systems-level intervention. The primary outcome is the percent of patients with
at least one living donor inquiry. Secondary outcomes will test the effect of the intervention on key constructs
of the Information-Motivation-Behavioral Skills model to determine possible mediating pathways. Participants
will undergo baseline assessment, access either the intervention or control educational materials, and
complete an immediate follow-up assessment. Living donor inquiries will be examined over the subsequent 12
months. The process evaluation will utilize transplant center administrative records, immediate follow-up data
from participants, website usage statistics, and study records. It is anticipated that achievement of these aims
will yield outcomes with great clinical...

## Key facts

- **NIH application ID:** 9919556
- **Project number:** 5R01DK114891-04
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Kimberly Ruth Jacob Arriola
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $231,134
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9919556

## Citation

> US National Institutes of Health, RePORTER application 9919556, Reducing disparities in living donor transplant among African Americans (5R01DK114891-04). Retrieved via AI Analytics 2026-06-07 from https://api.ai-analytics.org/grant/nih/9919556. Licensed CC0.

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