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Transition from donor candidates to live kidney donors: the impact of race and undiagnosed medical disease states
Author(s) -
Norman Silas P.,
Song Peter X.K.,
Hu Youna,
Ojo Akinlolu O.
Publication year - 2011
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/j.1399-0012.2009.01188.x
Subject(s) - medicine , donation , kidney donation , kidney transplantation , kidney disease , logistic regression , odds ratio , transplantation , creatinine , economics , economic growth
Norman SP, Song PXK, Hu Y, Ojo AO. Transition from donor candidates to live kidney donors: the impact of race and undiagnosed medical disease states.
Clin Transplant 2011: 25: 136–145. © 2009 John Wiley & Sons A/S. Abstract: Background: Living kidney donors (LKD) allow for increased access to lifesaving organs for transplantation. There is a relative paucity of African American (AA) live kidney donors. The prevalence of medical disease in LKD candidates has not been well studied. We examined the medical limitations to living kidney donation in a large Midwestern transplant center. Methods: A total of 2519 adults (age ≥ 18 ) evaluated as potential LKD (PD) between January 1, 1996 and June 30, 2006 were prospectively followed until evaluation outcome (completed live donation, medical exclusion from live donation, non‐medical exclusion from live donation). Logistic regression was used to examine the effect of age on donor exclusion, and chi‐square tests were used to compare the likelihood of donor exclusions between racial and gender groups. Results: Sixty percent of PD were female (n = 1300), and 86% were Caucasian (CA) (n = 1862). Overall, 48.7% of PD who underwent evaluation became LKD. The odds of donation were 52% lower in AA compared to CA (OR 0.48 p < 0.001). Among PD excluded from donation, the most common medical diagnoses were hypertension (HTN) (24.7%), inadequate creatinine clearance (10.6%) and a positive final crossmatch (10.5%). The rate of PD exclusion for obesity was twofold higher in AA compared to CA (12.8% vs. 5.8%, p < 0.001). Conclusions: Hypertension in PD is equally significant barrier to living kidney donation in AA and CA whereas obesity is a greater barrier in AA.