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Kidney Week

Abstract: TH-PO876

Sociodemographic Barriers to Interest and Pursuit of Living Donation Among ESKD Patients

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Walker, Adam G., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Sibbel, Scott, Davita Clinical Research, Minneapolis, Minnesota, United States
  • Maixner, William D., DaVita Inc, Denver, Colorado, United States
  • Colson, Carey, Davita Clinical Research, Minneapolis, Minnesota, United States
  • O'Shea, Michael, DaVita Inc, Denver, Colorado, United States
  • Brunelli, Steven M., Davita Clinical Research, Minneapolis, Minnesota, United States
  • Tentori, Francesca, Davita Clinical Research, Minneapolis, Minnesota, United States
Background

Living donor kidney transplants result in better patient and graft survival compared to deceased donor kidney transplants. Despite these benefits, only 23% of all kidney transplants in 2022 were from a living donor. To provide insight of potential barriers to living donation, we quantified the associations of interest in, and pursuit of, living donor transplant with geographic, demographic, and socioeconomic factors among end-stage kidney disease (ESKD) patients.

Methods

This was a retrospective study of 151,656 adult ESKD patients on dialysis for whom preferences and potential pursuit of transplant status were documented. Publicly available data sources were used for classification of socioeconomic status. Outcomes considered were interest in living donation and separately, pursuit of a living donation. Associations between patient characteristics and outcomes were quantified with odds ratios and 95% confidence intervals derived from multivariate logistic regression models assuming a binomial distribution.

Results

For the 59,893 patients in whom interest was recorded, 11,675 (19.5%) were interested in living donor transplant. Among those interested, 7,376 (63.2%) reported having pursued a living donation. The following factors were associated with interest in living donation: age at dialysis start, race/ethnicity, sex, diabetes status, insurance type at dialysis start, kidney education attendance, and poverty level. The following factors were associated with pursuit of a living donation: age at dialysis start, race/ethnicity, and insurance type at dialysis start. Both interest and pursuit of living donation varied by state, but no obvious regional trends were observed.

Conclusion

Our results identify subgroups of patients who could potentially benefit from additional education regarding living donor transplant. This information may be useful in the design of interventions to increase living donor kidney transplantation rates.