LIVING KIDNEY DONORS REQUIRING TRANSPLANTATION: FOCUS ON AFRICAN AMERICANS.Room: Ballroom B
Eric M Gibney, Amit X Garg, Anne L King, Chirag R Parikh. Nephrology, Virginia Commonwealth University, Richmond, VA; Nephrology and Epidemiology, London Health Sciences Centre, London, ON Canada; Nephrology, Yale University, New Haven, CT.
Introduction: While long term adverse outcomes after kidney donation are relatively uncommon, ESRD has been reported following donation. Better knowledge of this risk guides donor selection, informed consent and long-term follow-up. We hypothesized that despite intensive screening of donors, African Americans (AA)would have increased risk of ESRD after donation than other ethnic groups.
Methods: The UNOS/OPTN database was searched for patients who had previouly donated a kidney and were placed on the kidney transplant waiting list between 1993 and 2005. To determine if the risk of donation may be higher in African Americans, we analyzed race of all living donors over the same time period and compared the frequencies by use of Chi-square testing.
Results: In the years 1993 - 2005, UNOS recorded 62,327 live donations. 8889 donors (14.3%) were AA and 42,419 (68.1%) were Caucasian (C). Over this same time period, 102 patients who had donated a kidney were placed on the waiting list. While AA comprised 14.3% of living kidney donors, they constituted 45% of donors on the waiting list (p<0.001). Conversely, C were the majority of donors (68.1%) but represented only 41% of those listed (p<0.01). Frequencies of listing for Asian, Hispanic, and Native American donors were not statistically different than their frequencies of donation. Median time from donation to listing was 18 years, indicating a long lag time between donation and ESRD for most subjects.
Conclusion: While the risk of ESRD is low following kidney donation, at least 102 donors have been placed on the kidney transplant waiting list. Other patients may have reached ESRD but were not evaluated or approved for transplantation. In the general population AA have an increased risk of ESRD. This trend appears similar and may be exaggerated in those individuals who become donors. Because of the large time lapse between donation and ESRD, the frequency of this event may increase substantially in the future as the number of living donors has increased dramatically. The truth of this observation requires examination in a prospective long-term study of donors and non-donor controls including adequate numbers of AA.
Keywords: African-American; Donation; Outcome; Risk factors
Tuesday, July 25, 2006 10:30 AM
Concurrent Session 42: Organ Allocation (10:30 AM-12:30 PM)