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Kidney Week

Abstract: FR-PO0953

Living Kidney Donor's Residential Neighborhood: Driver or Barrier of Post-Transplant Follow-Up?

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Li, Yiting, New York University Grossman School of Medicine, New York, New York, United States
  • Menon, Gayathri, New York University Grossman School of Medicine, New York, New York, United States
  • Kim, Byoungjun, New York University Grossman School of Medicine, New York, New York, United States
  • Demarco, Mario, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Orandi, Babak, New York University Grossman School of Medicine, New York, New York, United States
  • Bae, Sunjae, New York University Grossman School of Medicine, New York, New York, United States
  • Wu, Wenbo, New York University Grossman School of Medicine, New York, New York, United States
  • Massie, Allan, New York University Grossman School of Medicine, New York, New York, United States
  • Henderson, Macey L., New York University Grossman School of Medicine, New York, New York, United States
  • Segev, Dorry L., New York University Grossman School of Medicine, New York, New York, United States
  • McAdams-DeMarco, Mara, New York University Grossman School of Medicine, New York, New York, United States
Background

Despite revised OPTN compliance thresholds, follow-up rates for living kidney donors (LKDs) remain low, reinforcing the need for both short- and long-term follow-up to support their health. LKDs residing in socioeconomically deprived neighborhoods, substandard built environments, or limited access to primary care, may face challenges in completing follow-ups.

Methods

We identified 86,267 adult (age≥18) LKDs from SRTR (2000-2022). Complete follow-up visits at 6-month (6M), 1-year (1Y), and 2-year (2Y) post-recovery were defined as complete and timely (±60 days of expected visit date) 9 clinical & 2 lab components. Neighborhood factors (socioeconomic, household, and transportation characteristics [ACS], and medically underserved area [MUA; HRSA]), were determined based on LKDs’ residential ZIP codes. We used multilevel logistic regression (random intercept: recovery center) to quantify the adjusted odds ratio (aOR) for complete 6M, 1Y, and 2Y follow-up visits.

Results

After adjusting for individual sociodemographic factors, LKDs residing in neighborhoods with lower educational attainment (aOR=0.18, 95%CI:0.17-0.19), higher unemployment (aOR=0.32, 95%CI:0.31-0.33), higher proportion of female-headed households (aOR=0.79, 95%CI:0.76-0.81), higher poverty (aOR=0.79, 95%CI:0.77-0.82), overcrowding (aOR=0.97, 95%CI:0.93-1.00), lower vehicle access (aOR=0.97, 95%CI:0.94-0.99), or designated as MUAs (aOR=0.96, 95%CI:0.93-1.00) were less likely to complete 6-month follow-up visits. Similar associations were observed for 1-year and 2-year complete follow-up visits.

Conclusion

LKDs residing in neighborhoods characterized by poor built and socioeconomic environments and limited primary care access were less likely to complete follow-up. The transplant community should closely monitor LKDs in these neighborhoods to improve post-donation follow-up.

Digital Object Identifier (DOI)