Grant: Travel Awards - Institute Community Support

End-stage renal disease is a serious illness with significant health consequences and high-cost treatment options. Living donor kidney transplantation (LDKT) is the most cost-effective treatment and has a better survival rate when compared to both dialysis and deceased donor kidney transplantation. Despite this, LDKT rates in Canada are decreasing and vary widely between provinces: <15%, 30-40%, and 50-60% of total transplants are from living donors in Quebec, Ontario, and British Columbia, respectively. Efforts to increase LDKT tend to focus on patient education and training, but are only modestly effective. In addition, they may have created an unfair system favouring patients with the resources and means to find living donors. Less attention has been paid to barriers at the level of the health professional. The role of health professionals in a patient's decision to pursue LDKT is well known, but what is not known is whether health professionals identify barriers to discussing living donation with patients and potential donors. We first conducted a preliminary study to explore these barriers. Using this data, we prepared a 24-question survey and distributed it to health professionals involved in the care of patients with kidney disease in these three provinces of Canada. Our hypothesis was that these barriers are more prominent in provinces with lower rates of LDKT. The goals of this study were to quantify and compare these barriers between provinces, as well as identify targeted and pragmatic interventions in each province. Future work will involve conducting surveys in other provinces of Canada and prospective trials to address barriers to LDKT at the level of the health professional. Our long-term goal is to improve health care delivery to patients with end stage renal disease by increasing LDKT rates.