Abstract: PO2082
African American Kidney Donor Denial
Session Information
- Transplantation: Clinical - Allocation, Evaluation, Prognosis, and Viral Onslaughts
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 1902 Transplantation: Clinical
Author
- Porter, Ivan E., Mayo Clinic's Campus in Florida, Jacksonville, Florida, United States
Background
Previous studies have demonstrated that the rate of living kidney donation is lower in African American (AA) compared to the Caucasian population but whether this low donation rate is related to higher denial rates in AA donors is unclear. Comorbidities play a major role in live donors exclusions, especially hypertension and DM, which could affect the pool of potential donors. The aim of our study is to report the rates and causes of living kidney donor denial in our facility and to further stratify the exclusion rate based on race.
Methods
A retrospective cohort study of 439 denied candidates (age ≥18) who underwent evaluation for living kidney donation at our facility in the period from 2006 to 2014 was performed. Donors underwent a 24 hour ambulatory blood pressure monitor, iothalamate GFR, 24 hour urinary protein excretion and CT angiography as part of their donor evaluations. Reasons for denying donors were identified and grouped into 4 groups: 1) Low GFR, 2) Anatomical variation 3) Hypertension and 4) Other causes.
Results
The cohort consisted of 84 AA, 304 Caucasian and 32 Hispanic donors. Hispanic donors were excluded from further analysis. AA donors were younger (P=0.01) compared to Caucasians. Day time and night time systolic and diastolic arterial blood pressure were comparable between AA and Caucasian (P>0.3 for all)
Table 1 summarizes the different reasons for donor denial by donor race. There was no difference between AA and Caucasians or Hispanics in the reason for denial for donation
Conclusion
In this limited study the reasons for denial of kidney donation was not different between AA and Caucasians. Given that the disparity remains, other causes for the low donation in the AA population should be explored and mitigated.
Potential Donor Characteristics
| AA donors n=84 | Caucasian Donors n=304 | p | |
| Caucasian Donors n=304 | 126 ± 15 | 127 ± 12 | 0.46 |
| Day time average diastolic BP | 76 ± 9 | 77 ± 9 | 0.43 |
| Night time average systolic BP | 114 ± 14 | 112 ± 16 | 0.39 |
| Night time average diastolic BP | 65 ± 8 | 65 ± 10 | 0.82 |
| Reason for Denial | |||
| Low GFR | 6 (8) | 31 (10) | 0.70 |
| Anatomical Variation | 18 (21) | 79 (26) | 0.64 |
| Hypertension | 19 (23) | 65 (21) | 0.70 |
| Other | 48 (57) | 164 (54) | 0.61 |