Abstract: FR-PO1147
What Predicts Donation After Living Kidney Donor Candidate Evaluation? Insights from a Novel US Registry
Session Information
- Transplantation: Clinical - Transplant Access, Recipient Evaluation, Living Donors, Pregnancy, and More
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2002 Transplantation: Clinical
Authors
- Lentine, Krista L., Saint Louis University, St. Louis, Missouri, United States
- Schnitzler, Mark, Saint Louis University, St. Louis, Missouri, United States
- Xiao, Huiling, Saint Louis University, St. Louis, Missouri, United States
- Potter, Thomas B., Houston Methodist, Houston, Texas, United States
- Al Ammary, Fawaz, University of California Irvine, Irvine, California, United States
- Agbim, Uchenna, Saint Louis University, St. Louis, Missouri, United States
- Waterman, Amy D., Houston Methodist, Houston, Texas, United States
Background
Currently, no mandated data source tracks living kidney donor (LKD) candidates or barriers to progression from evaluation to donation. Using the SRTR Living Donor Collective pilot registry, we examined factors associated with progression to donation.
Methods
Ten participating U.S. transplant centers registered LKD candidates seen for evaluation (06/01/18-11/30/24) in the SRTR Living Donor Collective based on data abstracted from medical records. Associations of baseline demographic, social, history, and clinical factors with the likelihood of donation within 1-year of evaluation (adjusted odds ratio, aOR) were evaluated by multivariate logistic regression with LASSO selection.
Results
Among 4,852 evaluated LKD candidates with a finalized donation decision, women (aOR, 1.28) and paired donation candidates (aOR, 1.30) had higher odds of donation, while Black candidates had lower odds than White candidates (aOR, 0.53). Lower education (aOR, 0.83), unemployment (aOR, 0.81), and being single or divorced (aOR, 0.75 and 0.85) were associated with lower odds of donation. Travel to the U.S. for transplant trended toward lower donation. Current smoking (aOR, 0.61), obesity (aOR, 0.81), hypertension (aOR, 0.84), kidney stone history (aOR, 0.72), and cancer history (aOR, 0.67) were also associated with lower odds of donation. Absence of APOL1 renal risk variants was associated with higher odds of donation (0 RRV; aOR, 1.91), while high-risk genotypes were associated with lower odds (2 RRV; aOR, 0.60).
Conclusion
LKD evaluation is increasingly sophisticated, incorporating tools such as genetic testing that may improve safety but also increase exclusions. Modifiable factors associated with lower likelihood of donation—including smoking, obesity, and socioeconomic stressors—may help identify targets for interventions to support safe donation.
Acknowledgment
Supported by a grant from the NIDDK (R01 DK137111-01).
Funding
- NIDDK Support