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Abstract: SA-PO796

Increasing Conversion Rates and Reducing Disparities: Determining Modifiable Predictors Associated With Donating a Kidney

Session Information

Category: Transplantation

  • 2002 Transplantation: Clinical

Authors

  • Waterman, Amy D., Houston Methodist, Houston, Texas, United States
  • Peipert, John D., Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
  • Graviss, Edward A., Houston Methodist Academic Institute, Houston, Texas, United States
  • Nguyen, Duc T., Houston Methodist Academic Institute, Houston, Texas, United States
  • Gaber, Ahmed Osama, Houston Methodist, Houston, Texas, United States
  • Meinders, Andrea M., Houston Methodist, Houston, Texas, United States
  • Moore, Linda W., Houston Methodist, Houston, Texas, United States
  • Weng, Francis L., Cooperman Barnabas Medical Center, Livingston, New Jersey, United States
Background

Potential living donors (PLD) may present for evaluation but not donate due to modifiable factors that could be intervened upon. From a longitudinal cohort study of 5 transplant centers, we examined how many PLDs of different races/ethnicities actually donated, how many were not ruled out who might still donate, and whether any modifiable factors were predictive of actual living donation (LD).

Methods

From 2017-2020, we surveyed 2184 PLDs about their demographic characteristics, their educational preparedness, LD readiness, and anxiety prior to evaluation. Using EMR review, we followed 1241 PLDs for up to 12 months who were not ruled out to determine whether they donated a kidney. We used multivariable logistic regression models to identify characteristics associated with donating with variable selection conducted using the least absolute shrinkage and LASSO methods.

Results

Of 2184 PLDs, 943 (43.2%) were ruled out for medical reasons, 704 (32.2%) dropped out, 130 (6.0%) were ruled out for modifiable reasons, and 407 (18.6%) donated. At the univariate level, PLDs who were Black (22.8%), Hispanic (22.4%), or of other races/ethnicities (20.6%) were less likely to donate than Whites (40.3%) and Asians (43%), with multilevel modeling revealing that Hispanics [OR: 2.25; 95% CI: 1.29, 3.95} remained less likely to donate than Whites after controlling for other factors (Table). Multivariate modeling also revealed that PLDs who had spoken to the kidney patient about donating, read information, and were in the Action Stage of readiness were 1.5-2.4 times more likely to donate.

Conclusion

Interventions focused on increasing living donors’ readiness and preparedness may reduce drop-out and increase the number of PLDs converting to actual LD.

Funding

  • Other NIH Support