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Lower Rates of Living Donor Kidney Transplantation(LD) Among African Americans: What Prevents Higher Rates of Donation?

A. Li, N. Foreman, M. Reissmann, C. Zuttermeister, A. Gilbert, M. Grafals, B. Javaid, S. Ghasemian, P. Abrams, M. Cooper, J. Verbesey.

MedStar Georgetown Transplant Institute, Washington, DC.

Meeting: 2016 American Transplant Congress

Abstract number: 535

Keywords: African-American, Donation, Kidney transplantation

Session Information

Date: Tuesday, June 14, 2016

Session Name: Concurrent Session: Living Kidney Donor Evaluation

Session Time: 4:30pm-6:00pm

 Presentation Time: 5:18pm-5:30pm

Location: Ballroom B

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Purpose: African Americans (AA) are less likely to undergo LD kidney transplantation. Reasons may include decreased health literacy, increased obesity, or hypertension. We sought to determine which stage of the donor evaluation process results in greatest loss of AA candidates.

Methods: Review of data from screening donor questionnaire(LDQ), lab testing and full-day evaluation for all potential donors between 2012 and 2015. Results from AA and non-AA candidates were compared using JMP Pro 11, and a chi-square test to assess for group differences.

Results: 530 potential donors were identified; 220 AA(42%), 310 non-AA(58%). Final donation rates were AA=9.1%, non-AA=19% (p=0.015). LDQ results eliminated 154 AA(70%) vs 179(57.7%) non-AA donors(p=0.004). Hypertension eliminated more AA donors (7.3%) than non-AA(1%)(p=0.0001). Lab completion rates were similar (AA=93.9%, non-AA=90.1%, NS) as were acceptable labs (AA=72.6%, Non-AA=78.9%, NS). Of those eligible for full evaluation, AA and non-AA completion rates were similar (AA=91.1%, non-AA=97.8%, NS). AA donors were more likely to be family members (80% vs. 69%,p=<0.001)and AA parents were less likely to qualify to donate to their children (3.6% vs 9%,p=0.015) than non-AA donors. AA children are more likely to donate to their parent (22.7% vs. 12%, p=0.014) with AA daughters most likely to donate (p=0.007).

  LDQ Completed LDQ OK Labs Completed Labs OK Evaluation Completed Donation Donation Complete (Of Total)
AA 220

66/220  (30%)

62/66 (93.9%) 45/62 (72.6%) 41/45   (91.1%) 20/41 (48.8%) 20/220 (9.1%)
Non-AA  310  131/310   (42.2%) 118/131  (90.1%) 93/118   (78.9%) 91/93     (97.8%) 59/91   (64.8%) 59/310 (19%)
p= N/A 0.004 0.36 NS 0.35 NS 0.07 NS  0.08 NS  0.015
Total  530

197/530 (37.2%)

 180/197 (91.4%)  138/180 (76.7%)  132/138 (95.7%)  79/132 (59.8%)  79/530 (14.9%)

Conclusions: Hypertension was the only medical disqualification occurring more frequently in AA donors. Donation rates between eligible AA and Non-AA donors were similar, but significantly less when looking at the original pool of potential donors. The majority of AA donors were eliminated after the LDQ, suggesting initial interest in donation is not sustained. LD educational outreach, early intervention, and rapid workup tempo may increase AA kidney donation.

CITATION INFORMATION: Li A, Foreman N, Reissmann M, Zuttermeister C, Gilbert A, Grafals M, Javaid B, Ghasemian S, Abrams P, Cooper M, Verbesey J. Lower Rates of Living Donor Kidney Transplantation(LD) Among African Americans: What Prevents Higher Rates of Donation? Am J Transplant. 2016;16 (suppl 3).

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To cite this abstract in AMA style:

Li A, Foreman N, Reissmann M, Zuttermeister C, Gilbert A, Grafals M, Javaid B, Ghasemian S, Abrams P, Cooper M, Verbesey J. Lower Rates of Living Donor Kidney Transplantation(LD) Among African Americans: What Prevents Higher Rates of Donation? [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/lower-rates-of-living-donor-kidney-transplantationld-among-african-americans-what-prevents-higher-rates-of-donation/. Accessed March 4, 2021.

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