Kidney Week

Abstract: SA-PO979

Evolution of Biologically Related Living Kidney Donations in the United States over 35 Years

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Al Ammary, Fawaz, University of California Irvine, Irvine, California, United States

Fawaz Al Ammary, MD, PhD

• Adeyemo, Simeon, University of California Irvine, Irvine, California, United States

Simeon Adeyemo, MS

• Lentine, Krista L., Saint Louis University, Saint Louis, Missouri, United States

Krista L. Lentine, MD, PhD, FASN

• Muzaale, Abimereki, Johns Hopkins University, Baltimore, Maryland, United States

Abimereki Muzaale, MD, MPH

Background

Living kidney donors have declined over the last two decades, mainly driven by biologically related donors with the recipient. We sought to understand the interplay of biological donor-recipient relationship and race to guide future interventions.

Methods

We used the Scientific Registry of Transplant Recipients to examine changes in biologically related living kidney donations over time. A priori, we stratified the analyses by era (1988–2004 and 2005–2022) and donor race (Black, Hispanic, and White/others). We used Poisson regression to estimate change in number of donors per 5-year increment (incidence rate ratio, IRR).

Results

Of 106,033 biologically related donors (43% full sibling, 25% offspring, 20% parents, and 12% non-first-degree relative donors) 71% were White, 14% Black, and 15% Hispanic.

The rates of biologically related donors between 1988 and 2004 increased across race. For every 5-year increment, White related donors increased by 31% (IRR _1.291.31_1.32), Black related donors increased by 52% (IRR _1.491.52_1.56), and Hispanic related donors increased by 55% (IRR _1.511.55_1.59) . Conversely, the rates of biologically related donors between 2005 and 2022 decreased across race. For every 5-year increment, White related donors decreased by 18% (IRR _0.820.82_0.83), Black related donors decreased by 25% (IRR _0.730.75_0.77), and Hispanic related donors decreased by 9% (IRR _0.890.91_0.93).

Conclusion

Our study highlights opportunites to reduce barriers to biologically related donations among racial/ethnic minorities and the socioeconomically disadvantaged healthy adults. Efforts are needed to reduce hurdles for biologically related donors, potentially by providing outreach education, easing access to donor evaluation, offering social and financial support, and assuring post-donation follow-up care.

Funding

• NIDDK Support