Progressnotes - October/November 2012
- About MUSC Health
For patients with end-stage renal disease, kidney transplants are quite literally a matter of life and death. A kidney transplant can add ten or more good-quality years to the life of a patient with endstage renal disease, and yet as many as 25% of patients on dialysis die each year while awaiting a transplant.
Of the 100,000 US patients who are placed on the waiting list for kidney transplants each year, only slightly over 20,000 actually receive kidneys (16,000 from deceased donors; 6,500 from living donors). The situation is particularly dire among the African-American community: in South Carolina, blacks constitute 65% of patients on dialysis but represent 14% or less of living donors. If supply is ever to meet demand, the number of living donors, who can include not only family members but extended family, colleagues, friends, and church members, must dramatically increase.
According to Prabhakar Baliga, M.D., Chief of the Division of Transplant Surgery at MUSC, “the two main barriers to living donation are the recipient not being willing to ask for a donation and donors not following through on their commitment.” More than 50% of initially enthusiastic potential donors back out, many because they harbor misconceptions about the consequences of kidney donation (eg, many mistakenly believe that they will likely become diabetic or will not be able to have children).
In an age in which smart phones and tablet technology have penetrated deeply into the American way of life, with high adoption rates by minority populations (51% of African Americans have smart phones), technology likely offers the best way to dispel such misconceptions. Dr. Baliga and Frank A. Treiber, PhD, SmartState™ Endowed Chair in Technology at MUSC, were recently awarded an R01 grant in the amount of $1,290,625 by the National Institutes of Health/National Institute of Diabetes and Kidney Diseases to use technology, specifically iPADs, to do just that.
Drs. Baliga and Treiber will develop two separate educational programs, one for potential donors and one for patients in need of a transplant. These video clip modules, which will be watched on iPADs loaned to participants, will address many of these individuals’ common concerns and misconceptions and will feature not only past donors and recipients commenting on their own experience but also musical (eg, Darius Rucker) and athletic celebrities (eg, Carlos Dunlap) from South Carolina whose friends have been affected by chronic kidney disease. Before making these videos, Drs. Baliga and Treiber will run focus groups with various groups of African-American kidney donors and living donor recipients to identify all barriers to living kidney donation. Once the educational iPAD programs are developed, potential living donors and recipients will be able to participate in live video chat sessions via iPAD to discuss the videos with other potential donors or recipients, as well as with an African- American facilitator, who will be either a kidney donor or a living kidney transplant recipient.
Through this program, Drs. Baliga and Treiber are hoping to double the number of yearly living donations at MUSC (from 35–40 to 60–70 per year) and to provide a model to other hospitals seeking to enhance living donation. Ultimately, this creative use of technology could mean that many more lives are saved each year through kidney transplant.