Background: Comorbid conditions that exclude individuals from living kidney donation are highly prevalent in the United States, but the relationship between population characteristics and the rate of living donation is unknown.

Methods: Using data from the Organ Procurement and Transplantation Network, center rate of living kidney donation was defined as the proportion of transplants performed in 2013 that were from living kidney donors. State prevalence measures of population health and socioeconomic status were captured from the 2013 Behavioral Risk Factors Surveillance System. Generalized estimating equations were used to examine the association between prevalence factors and living donation rates, clustering by state.

Results: The median proportion of living donor kidney transplants was 30.8% (IQR: 28.1-46.2). State prevalence of population characteristics varied from 1.9% to 3.7% for kidney disease, 6.1% to 28.0% for no health insurance, and 2.9% to 8.8% for poor self-rated health (Figure). On exploratory analyses, several factors were significantly associated with rate of living donation. For every 1% increase in state prevalence of kidney disease, on average there was a 6.5% decrease (p < 0.001) in the rate of living donation. Similar results were seen for poor self-rated health (2.2% decrease, p=0.02), household income < $15,000 per year (0.6% decrease, p=0.06), and lack of insurance (0.5% decrease, p=0.01) and rate of living kidney donation. Conclusions: Center-level variation in living kidney donation was associated with population health and sociodemographic characteristics. Further examination of these factors in the context of patient and center-level barriers to living kidney donation is warranted.

CITATION INFORMATION: Reed R, Shelton B, MacLennan P, Hanaway M, Kumar V, Gaston R, Locke J. State Population Health and Center-Level Variation in Rate of Living Kidney Donation. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress