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Kidney Week

Abstract: FR-PO0998

Factors Affecting Wait Times in Living-Donor Kidney Transplant

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Chandrashekar, Sneha, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Shah, Divyash V., Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Kancherla, Pranav S., Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Bankulla, Misha R, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Tandukar, Srijan, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
Background

Living donor kidney transplant (LDKT) offers a life-saving option for patients with end stage kidney disease, reducing wait times compared to deceased donor transplants. However, the characteristics of candidates that wait a shorter period compared to those waiting longer is unclear. We stratified the cohort by duration of wait times for a LDKT to analyze characteristics.

Methods

We included adult LDKT recipients at the University of Pennsylvania between 1/1/2015 and 11/30/2023. The wait time for a LDKT was defined as the time from the date of waitlisting to time of transplant. Patient characteristics were analyzed based on wait times of <1 year, 1-2 years, and >2 years. Pertinent factors determining wait times for a well-matched LDKT offer were presented in a multidimensional heatmap.

Results

Candidates receiving directed donor LDKT experienced the shortest wait times across all height and blood type categories, whereas end-chain LDKT recipients had the longest wait times. Non-White candidates were more likely to wait >2 years. Most White candidates received LDKT within 1-2 years. Candidates with blood type B had longer wait times.

Conclusion

Blood type and the source of LDKT impacted wait times the most. Minorities waited longer for a LDKT, highlighting disparities in access to LDKT. Future studies should explore mechanisms driving these disparities.

1. Baseline Characteristics
 < 1 year (N=249)1-2 years (N=197)> 2 years (N=213)p-value
Recipient Age49 (15)47 (13)52 (12)0.002
Recipient Female Gender84 (33.7%)84 (42.6%)88 (41.3%)0.1
Type of Transplant   < 0.001
Directed Donor LDKT202 (81.1%)123 (62.4%)102 (47.9%) 
End Chain LDKT7 (2.8%)11 (5.6%)39 (18.3%) 
Paired Kidney Exchange LDKT40 (16.1%)63 (32.0%)72 (33.8%) 
Recipient Race   < 0.001
White159 (80.7%)202 (81.1%)136 (63.8%) 
Non-White34 (15.6%)51 (22.4%)77 (36.2%) 

Digital Object Identifier (DOI)