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To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

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Kidney Week

Abstract: FR-PO880

Causes of Living Donor Rejection: A Single Center Experience

Session Information

Category: Transplantation

  • 1802 Transplantation: Clinical


  • Lum, Erik Lawrence, David Geffen School of Medicine, Los Angeles, California, United States
  • Shen, Jenny I., LaBiomed at Harbor-UCLA, Torrance, California, United States
  • Beaumont, Jennifer L., Terasaki Research Institute, Los Angeles, California, United States
  • Kawakita, Satoru, Terasaki Research Institute, Los Angeles, California, United States
  • Waterman, Amy D., Transplant Research and Education Center/ Terasaki Research Institute, Los Angeles, California, United States
  • Rastogi, Anjay, Division of Nephrology, Los Angeles, California, United States
  • Gritsch, Hans Albin, UCLA, Los Angeles, California, United States

Living donor kidney transplantation (LDKT) is the preferred treatment for end stage kidney disease because it leads to better survival than either dialysis or deceased donor transplantation. Yet, the rate of LDKT has not grown despite high numbers of potential donors. Understanding the reasons that potential donors are rejected is key to developing effective interventions to increase LDKT.


In this single center retrospective observational study from UCLA Medical Center, both a transplant nephrologist and a transplant surgeon reviewed the medical records of all potential living donors presented to the living donor selection committee from 2009 to 2014 and coded the reasons they were rejected as donors. Reasons were categorized as medical, surgical, social, or “other”.


Out of 1370 patients, 55% (760) were accepted as potential donors, 16% (225) required further workup, and 29% (385) were denied as donors. 84% (323) of those rejected were rejected for multiple reasons (Figure). The top 3 most common reasons for rejection were medical: young age, family history of diabetes, and obesity. The top social reason was a prior history of psychiatric illness other than depression, and the top surgical reason for rejection was evidence of a renal lesion.


Most potential donors were denied for multiple reasons. Effective interventions to increase the rate of acceptance of potential donors will need to be multi-faceted since addressing just a single cause for rejection is unlikely to clear a potential donor for donation.