With an ever increasing kidney waiting list, a major goal is to expand living donor transplantation (LD). LD increases volume and provides higher quality, longer lasting grafts. We streamlined our donor evaluation process, investigated where potential donors are lost, and looked for specific targets for intervention.

Methods:Demographics and evaluation data were collected prospectively in a REDCap database. Online questionnaires (LDQ) and evaluation results were examined for all potential donors from 4/2015 to 9/2016. Chi-square test used to assess for group differences.

Results:985 potential donors completed the LDQ (45% Caucasian (CAU)/37% African American (AA)/18% Other). Over half the cases were closed before next step of lab testing despite multiple phone calls. 12% of CAU donors vs 34% AA donors ruled out for medical reasons or family history (p=0.006, Figure 1). Case closure reasons shown in Figure 2. Almost 1/3 opted out/no show. 20.1% of total potential donors proceeded to evaluation. Of all potentials, only 15.2% end up donating (18.9% CAU vs 9.8% AA, p=0.0047).

Conclusions: Data from a high volume kidney transplant center demonstrates the very difficult task of bringing LDs to fruition, particularly in the AA community. Despite many attempts to engage donors, almost 2/3 of donors drop out early due to medical reasons or "opt out/no show." This partially reflects stringent screening, but also a very high initial donor decision to withdraw. Once patients come in for evaluation, a majority will proceed to transplant. Given this data, we changed our process so that potential donors come for early evaluation without any intervening steps. Future research will show if this prevents the dreaded loss of many potential donors early on.

CITATION INFORMATION: Verbesey J, Bacigalupo A, Gilbert A, Li A, Zuttermeister C, Grafals M, Moore J, Javaid B, Abrams P, Ghasemian S, Cooper M. Living Kidney Donors: Battling High Attrition Rates During Evaluation Process. Am J Transplant. 2017;17 (suppl 3).

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