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Abstract: SA-PO808

Concordance of Social Deprivation Among Living Kidney Donor-Recipient Pairs

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical


  • Bilen, Yara, Cleveland Clinic, Cleveland, Ohio, United States
  • Schold, Jesse D., Cleveland Clinic, Cleveland, Ohio, United States
  • Arrigain, Susana, Cleveland Clinic, Cleveland, Ohio, United States
  • Buchalter, Robert B., Cleveland Clinic, Cleveland, Ohio, United States
  • Huml, Anne M., Cleveland Clinic, Cleveland, Ohio, United States

Living kidney transplant is the most effective replacement therapy. Pervasive socioeconomic disparities in access to living kidney transplant exist and little is known about how closely socioeconomic indicators match within living donor-recipient pairs. We aimed to examine concordance of social deprivation indices (SDI) in living donor-recipient pairs.


We conducted a retrospective cohort study of living kidney donor-recipient pairs in the Scientific Registry of Transplant Recipients from 2010-2020. Living donors and kidney recipients were geocoded to link with a ZIP code tabulation area-level SDI and outcomes were stratified by donor type (altruistic, biological, non-biological and paired exchange). The association between donor-recipient SDIs were evaluated using Pearson’s correlation.


59,575 living donor-recipient pairs (≥18 years old) with documented residential ZIP codes were identified. We characterized the donor type among 58,589 pairs: 2,343 altruistic, 26,363 biological, 22,698 non-biological, and 7,185 paired. The mean donor and recipient SDI were 45, with 26% of both donors and recipients coming from the lowest SDI quintile. The mean SDI for donor and recipient was 47.2 vs. 47.4 for biological, 42.5 vs. 42.7 for non-biological, 42.5 vs. 44.7 for paired, and 43.2 vs. 46.7 for altruistic. Among biological and non-biological donor-recipient pairs, SDI was highly correlated (Pearson Rho 0.51, and 0.56 respectively). In contrast, the SDI of altruistic donor-recipient pairs did not show a clear correlation (Rho = 0.15) except for two clusters in lowest and highest SDI. Paired exchanges were clustered at the lowest SDI (Rho=0.10 Fig.1).


Living kidney transplants occur across all SDIs, with different representation by donor types. By understanding these differences, we can leverage community resources to better support living donation in areas of neighborhood disadvantage.

Fig.1 SDI comparision by donor type