TY - JOUR
T1 - The changing landscape of live kidney donation in the United States from 2005 to 2017
AU - Al Ammary, Fawaz
AU - Bowring, Mary Grace
AU - Massie, Allan B.
AU - Yu, Sile
AU - Waldram, Madeleine M.
AU - Garonzik-Wang, Jacqueline
AU - Thomas, Alvin G.
AU - Holscher, Courtenay M.
AU - Qadi, Mohamud A.
AU - Henderson, Macey L.
AU - Wiseman, Alexander C.
AU - Gralla, Jane
AU - Brennan, Daniel C.
AU - Segev, Dorry L.
AU - Muzaale, Abimereki D.
N1 - Publisher Copyright:
© 2019 The American Society of Transplantation and the American Society of Transplant Surgeons
PY - 2019
Y1 - 2019
N2 - The number of live kidney donors has declined since 2005. This decline parallels the evolving knowledge of risk for biologically related, black, and younger donors. To responsibly promote donation, we sought to identify declining low-risk donor subgroups that might serve as targets for future interventions. We analyzed a national registry of 77 427 donors and quantified the change in number of donors per 5-year increment from 2005 to 2017 using Poisson regression stratified by donor–recipient relationship and race/ethnicity. Among related donors aged <35, 35 to 49, and ≥50 years, white donors declined by 21%, 29%, and 3%; black donors declined by 30%, 31%, and 12%; Hispanic donors aged <35 and 35 to 49 years declined by 18% and 15%, and those aged ≥50 increased by 10%. Conversely, among unrelated donors aged <35, 35 to 49, and ≥50 years, white donors increased by 12%, 4%, and 24%; black donors aged <35 and 35 to 49 years did not change but those aged ≥50 years increased by 34%; Hispanic donors increased by 16%, 21%, and 46%. Unlike unrelated donors, related donors were less likely to donate in recent years across race/ethnicity. Although this decline might be understandable for related younger donors, it is less understandable for lower-risk related older donors (≥50 years). Biologically related older individuals are potential targets for interventions to promote donation.
AB - The number of live kidney donors has declined since 2005. This decline parallels the evolving knowledge of risk for biologically related, black, and younger donors. To responsibly promote donation, we sought to identify declining low-risk donor subgroups that might serve as targets for future interventions. We analyzed a national registry of 77 427 donors and quantified the change in number of donors per 5-year increment from 2005 to 2017 using Poisson regression stratified by donor–recipient relationship and race/ethnicity. Among related donors aged <35, 35 to 49, and ≥50 years, white donors declined by 21%, 29%, and 3%; black donors declined by 30%, 31%, and 12%; Hispanic donors aged <35 and 35 to 49 years declined by 18% and 15%, and those aged ≥50 increased by 10%. Conversely, among unrelated donors aged <35, 35 to 49, and ≥50 years, white donors increased by 12%, 4%, and 24%; black donors aged <35 and 35 to 49 years did not change but those aged ≥50 years increased by 34%; Hispanic donors increased by 16%, 21%, and 46%. Unlike unrelated donors, related donors were less likely to donate in recent years across race/ethnicity. Although this decline might be understandable for related younger donors, it is less understandable for lower-risk related older donors (≥50 years). Biologically related older individuals are potential targets for interventions to promote donation.
KW - clinical research/practice
KW - donor nephrectomy
KW - donors and donation: living
KW - kidney transplantation/nephrology
KW - kidney transplantation: living donor
KW - registry/registry analysis
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U2 - 10.1111/ajt.15368
DO - 10.1111/ajt.15368
M3 - Article
C2 - 30903733
AN - SCOPUS:85065413055
SN - 1600-6135
VL - 19
SP - 2614
EP - 2621
JO - American Journal of Transplantation
JF - American Journal of Transplantation
IS - 9
ER -