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The National Landscape of Living Kidney Donor Follow‐Up in the United States
Author(s) -
Henderson M. L.,
Thomas A. G.,
Shaffer A.,
Massie A. B.,
Luo X.,
Holscher C. M.,
Purnell T. S.,
Lentine K. L.,
Segev D. L.
Publication year - 2017
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.14356
Subject(s) - medicine , united network for organ sharing , organ procurement , demography , donation , logistic regression , odds , organ donation , odds ratio , single center , transplantation , family medicine , gerontology , surgery , sociology , economics , liver transplantation , economic growth
In 2013, the Organ Procurement and Transplantation Network ( OPTN )/ United Network for Organ Sharing ( UNOS ) mandated that transplant centers collect data on living kidney donors ( LKD s) at 6 months, 1 year, and 2 years postdonation, with policy‐defined thresholds for the proportion of complete living donor follow‐up ( LDF ) data submitted in a timely manner (60 days before or after the expected visit date). While mandated, it was unclear how centers across the country would perform in meeting thresholds, given potential donor and center‐level challenges of LDF . To better understand the impact of this policy, we studied Scientific Registry of Transplant Recipients data for 31,615 LKD s between January 2010 and June 2015, comparing proportions of complete and timely LDF form submissions before and after policy implementation. We also used multilevel logistic regression to assess donor‐ and center‐level characteristics associated with complete and timely LDF submissions. Complete and timely 2‐year LDF increased from 33% prepolicy (January 2010 through January 2013) to 54% postpolicy (February 2013 through June 2015) (p < 0.001). In an adjusted model, the odds of 2‐year LDF increased by 22% per year prepolicy (p < 0.001) and 23% per year postpolicy (p < 0.001). Despite these annual increases in LDF , only 43% (87/202) of centers met the OPTN / UNOS ‐required 6‐month, 1‐year, and 2‐year LDF thresholds for LKD s who donated in 2013. These findings motivate further evaluation of LDF barriers and the optimal approaches to capturing outcomes after living donation.