Rachel Patzer Research Update: RaDIANT Study Expansion & Video Outreach

April 2016

At any given moment, Rachel Patzer, PhD, director of the Emory Transplant Health Services and Outcomes Research Program, has various funded studies in play concerned with inequities in solid organ transplantation. One of these, the RaDIANT (Reducing Disparities in Access to Kidney Transplantation) Community Study, received an additional $2.6 million over five years from the National Institutes of Minority Health and Health Disparities. The renewal will expand the grant's Georgia boundaries to include South Carolina and North Carolina.

The RaDIANT study, a regionally-coordinated intervention to reduce racial disparities in access to kidney transplantation in the Southeastern U.S., was inspired by research Dr. Patzer's group published in the August 2015 edition of the Journal of the American Medical Association (JAMA). The study showed that only 28% of Georgia dialysis patients were referred to one of the state's three adult kidney transplant centers within a year of starting dialysis. Also, while African American patients were 20% more likely to be referred for transplant within one year of starting dialysis compared to white patients, they were nearly 30% less likely to be waitlisted for kidney transplant within one year of referral.

In the Georgia-based phase of RaDIANT, Dr. Patzer and a team that included co-investigator Stephen Pastan, MD, medical director of the Emory kidney and pancreas transplant program and chair of the Southeastern Kidney Transplant Coalition, developed and initiated behavioral interventions designed to increase referral for transplantation and reduce racial disparities at both the patient and dialysis facility levels. These interventions included educational seminars, peer-to-peer mentoring, facility-specific feedback reports detailing transplant referral data for the particular facility compared to the state average, and other measures.

"Over time, it appears that our RaDIANT interventions in Georgia did indeed contribute to nearly doubling of referral for transplantation and reducing racial disparities," says Dr. Patzer. "The new grant will go a long way to helping us expand this work to dialysis facilities in North Carolina and South Carolina and test whether we find similar effects in a larger, regional population. We also want to ensure that the patients who were referred for transplant show up to start the transplant evaluation process."

When former NFL player Donald Jones recently visited kidney transplant patients at Emory University Hospital and faculty and staff at the Emory Transplant Center, Dr. Patzer took the opportunity to interview him for an educational video series about transplant for dialysis patients. The series is a component of Dr. Patzer's NIH-funded ASCENT study (Allocation System Changes for Equality in kidNey Transplantation), which is examining the impact of changes to the allocation policies of the Organ Procurement and Transplantation Network of the United Network for Organ Sharing on racial disparities in kidney transplantation access.

Mr. Jones' Emory stop was part of a national tour to raise awareness about IgA nephropathy, a disease that occurs when the antibody immunoglobulin A (IgA) lodges in the kidneys and causes inflammation. Mr. Jones received a kidney transplant in 2013 following kidney disease initiated by IgA nephropathy.

"Donald was very gracious and friendly, and his recognition factor combined with the power and inspiration of his story made him a perfect spokesperson for the benefits of transplantation and why patients should discuss the option with their providers and family members," says Dr. Patzer. When completed, the video will be distributed to dialysis centers throughout the U.S. that have low rates of transplant or racial disparities in access to transplant.

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