Assessing Knowledge About Living Kidney Donation Among Transplant Candidates and Relationship to Seeking a Living Donor

INTRODUCTION: Despite well-established advantages of living-donor kidney transplantation (LDKT), LDKT growth has stagnated. Barriers to seeking a living donor include insufficient knowledge among candidates and discomfort discussing LDKT. This study evaluates interactions between knowledge, comfort, and action among transplant candidates. METHODS: Adult kidney transplant candidates (n = 190) completed a pre-education questionnaire measuring perceived knowledge, actual knowledge, comfort, and action related to living donation. RESULTS: Mean age was 53 ± 14 years with 48% Black and 61% male respondents. Higher perceived knowledge was associated with action (excellent/very good/good knowledge: 62% action vs. fair/poor knowledge: 45% action, p = 0.02). Higher composite comfort scores also correlated with action (mean 42 ± 16 action vs. 34 ± 16 no action, p = 0.0004). Actual knowledge did not differ according to action (median [IQR] 19 [18-21] action vs. 19 [17-21] no action, p = 0.53). There was a lower mean knowledge score among Black candidates, but numerical differences were small (Black: 19 [17-20] vs. white: 20 [18-21], p = 0.01). Younger patients were more likely to report action (mean 51 ± 14 years action vs. 56 ± 12 years no action, p = 0.01), and there was a trend toward a higher proportion of female candidates reporting action (female: 60% vs. male: 51%, p = 0.24). CONCLUSION: Actual LDKT knowledge among transplant candidates did not predict action in approaching a potential living donor, whereas younger age, perceived knowledge, and comfort did. Educational programs targeting improving comfort and perceived knowledge are needed, particularly among older candidates.