Background: The prevalence of comorbid disease continues to increase in the United States, particularly in areas like the Stroke Belt, but it is unknown whether these changes have impacted rates of living kidney donation in the United States.

Methods: Using data from the Organ Procurement and Transplantation Network, center rate of living kidney donation was defined as the proportion of all transplants performed in 2003 and 2013 from living donors. State prevalence measures of population health and socioeconomic status were captured from the 2003 and 2013 Behavioral Risk Factors Surveillance System. Generalized estimating equations were used to examine the association between prevalence factors and living kidney donation rates, clustering by state and center.

Results: The median proportion of living donor kidney transplants in 2003 was 41.9% (IQR: 32.7-55.6), while the median proportion decreased to 35.4% in 2013 (IQR: 28.1-46.2, p < 0.001). This difference remained on adjusted analyses, with the rate of living kidney donation on average 7% lower in 2013 when compared to 2003 (p=0.001) (Table). Centers in states defined as the Stroke Belt had an average rate of living donation that was 5.8% lower than states not in this region, independent of year. Conclusions: While the rate of living kidney donation overall has decreased in the last decade, there were also disparities in living kidney donation by location, particularly in the Stroke Belt, an area known to have increased rates of comorbid diseases considered contraindications to living kidney donation.

CITATION INFORMATION: Reed R, Shelton B, MacLennan P, Hanaway M, Kumar V, Gaston R, Locke J. Lower Rates of Living Donation Among Transplant Centers Located in the Stroke Belt. Am J Transplant. 2017;17 (suppl 3).

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