Living donation is decreasing in the US even as the number of candidates listed for renal transplant continues to rise. We sought to evaluate the characteristics of those candidates who find living donors.

Using the SRTR database, all adult living donor (LD) kidney transplant recipients between 2000 and 2010 were reviewed and compared to all candidates listed for kidney or kidney pancreas transplant during this time (n=290 127). Cox proportional hazard modeling was done to determine the independent effect of candidate characteristics on likelihood of receiving a LD transplant. Covariates in the model included candidate age, gender, race/ethnicity, ABO type, PRA, etiology of kidney disease, dialysis status at listing, initial list status (active vs. inactive), primary insurance, educational attainment, number of unique transplants candidate listed for, organ procurement organization of first listing, pancreas listing, and list year.

Candidate factors associated with achieving LD transplant included younger age, Caucasian race, private insurance, and higher level of education. Table 1 shows the hazard ratios of LD transplant based on multivariate analysis of candidate characteristics.

The strong influence of socioeconomic and financial factors in attaining LD transplant suggests that improved financial support for donors may be needed to improve LD rates among historically underserved populations.

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