Abstract: FR-PO0968
Use of Genetic Testing in Living-Donor Candidate Evaluation: Survey of US Transplant Center Practices
Session Information
- Transplantation: Clinical - Pretransplantation, Living Donation, and Policies
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Lentine, Krista L., Saint Louis University, St. Louis, Missouri, United States
- Daloul, Reem, Allegheny Health Network, Pittsburgh, Pennsylvania, United States
- Lee, Brian, The University of Texas at Austin, Austin, Texas, United States
- Mejia, Christina Irene, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Garg, Neetika, University of Wisconsin-Madison, Madison, Wisconsin, United States
- Rodig, Nancy MacDonald, Boston Children's Hospital, Boston, Massachusetts, United States
- Tabriziani, Hossein, Natera, San Carlos, California, United States
- Thomas, Christie P., University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
- Gordon, Elisa J., Vanderbilt University, Nashville, Tennessee, United States
- Freese, Margaret E., University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States
- Schlondorff, Johannes S., The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
- Caliskan, Yasar, Saint Louis University, St. Louis, Missouri, United States
Background
Genetic testing is increasingly used in the evaluation of living kidney donor (LKD) candidates. To help understand the landscape of current practices, we surveyed U.S. LKD program staff.
Methods
An online survey was designed by a multidisciplinary workgroup and distributed the survey to staff at U.S. LKD programs (2025-underway) using the Qualtrics survey platform.
Results
Among 46 center respondents to date, most (91%) reported some use of genetic testing in LKD evaluation practice. Selection criteria for genetic testing included candidates with a family history of known or possible genetic disease (100%) or with family of ESKD of unknown etiology (67%), all candidates of African ancestry (39%), or young candidates below an age threshold (16%) (Fig. A). Clinical impacts of positive genetic test findings led to a change in donation plan (73%), referral to genetic counseling and possible further genetic assessment (53%), testing at-risk family members (33%), and discussion around family planning (17%) (Fig. B). The most commonly ordered testing type was comprehensive panels (67%), with infrequent use of single gene panels (3%). Reasons for not ordering genetic testing include lack of comfort in interpreting results. Access to genetic counseling and better support for results interpretation were recommended.
Conclusion
LKD programs consider many factors when selecting candidates for genetic testing, most commonly family history. Positive genetic testing often impacts clinical practice. Expansion of this survey will support ongoing discussion of resource and educational supports to improve the use of genetic testing for LKD candidate evaluation.
Funding
- Private Foundation Support