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Kidney Week

Abstract: PO2079

Characteristics of Potential and Actual Living Kidney Donors: A Single-Center Experience

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Cholin, Liza, Cleveland Clinic, Cleveland, Ohio, United States
  • Schold, Jesse D., Cleveland Clinic, Cleveland, Ohio, United States
  • Poggio, Emilio D., Cleveland Clinic, Cleveland, Ohio, United States
  • Sedor, John R., Cleveland Clinic, Cleveland, Ohio, United States
  • Huml, Anne M., Cleveland Clinic, Cleveland, Ohio, United States
Background

Living kidney donors contribute only 28% of all transplanted kidneys. Our study aimed to examine characteristics of potential compared to actual living kidney donors, in order to better understand barriers to successful donation.

Methods

We performed a retrospective analysis of 1,815 intake forms completed by kidney donor candidates from 2016-2018 at a single transplant center. We analyzed data from all potential donors who completed the intake until they became ineligible or withdrew, or, until donation was reached. Baseline characteristics were compared between potential and actual donor groups.

Results

The donation process was deconstructed into 5 steps. The percentage of potential donor drop out at each step and the most common reason for drop out are shown in Table 1. Of the 125 actual donors, 115 (94.3%) were white and 81 (64.8%) were female. A family member was more likely than an unrelated individual to complete the process. At the intake step 35.5% of potential donors identified as family of the potential recipient; at donation 72.7% were family, p <0.001. Many potential and actual donors were referred by the transplant candidate (56.0% and 43.5%, respectively). Social media networking was a larger contributor to the potential donor pool than a source for actual donors (16.5% in potential donors v 2.4% in actual donors, p <0.0001). There were no significant differences between potential and actual donor group with respect to substance use, marital status, level of education, and employment status.

Conclusion

Kidney donor interest is high in the early steps, but few donor candidates become actual donors. A family relationship increases the likelihood a potential donor will become an actual donor. There is a significant drop out of potential donors for incompatible immunologic testing. Our ability to track all potential donors from initial touchpoint to transplant center will help us develop interventions to counteract identified barriers to successful donation, including better outreach to minority populations and education about kidney exchange programs.

Table 1: LKD Candidate Drop Out by Donation Step
 Intake QuestionnaireDonor Immunologic Compatibility TestingClinical EvaluationSelection Committee ReviewSuccessful Donation
Number of potential donors (% of total)1266 (69.8)305 (16.8)53 (2.9)66 (3.6)125 (6.9)
Most common reason for drop out (% at each step)No response to follow-up phone call (23.9)Incompatible crossmatch (36.1)Failure to complete required medical testing (41.5)Medical disqualification (54.6)N/A

Funding

  • NIDDK Support