Living Kidney Donor Phenotype and Likelihood of Postdonation Follow-up

Abstract

Background

The Organ Procurement and Transplantation Network requires that United States transplant centers maintain follow-up with living donors for 2 years postdonation, but lack of donor follow-up is pervasive. Donor characteristics, including younger age, minority race, and lower education, have been associated with incomplete follow-up, but it is unknown whether altruistic donors, having no prior connection to their recipient, differ from traditional donors in their likelihood of follow-up.

Methods

Utilizing Scientific Registry of Transplant Recipients data, we examined all adult living kidney donors from 2005–2015 (n=63 592) classified as altruistic or traditional, and compared likelihood of 6-month medical follow-up using modified Poisson regression.

Results

Altruistic donors did not differ from traditional donors in likelihood of follow-up (aRR: 1.02, 95% CI: 0.99–1.06). Among previously identified at-risk subgroups, however, altruistic donors were more likely to have follow-up than their traditional counterparts, including those who were younger (aRR: 1.04, 95% CI: 1.00–1.09), had less than college education (aRR: 1.05, 95% CI: 1.00–1.11), and were unmarried (aRR: 1.08, 95% CI: 1.04–1.12). Having medical follow-up at 6 months was significantly associated with having follow-up at 1 (aRR: 1.84, 95% CI: 1.75–1.93) and 2 years (aRR: 1.63, 95% CI: 1.56–1.70) postdonation.

Conclusions

These data provide additional granularity on living donor phenotypes associated with short-term (6 month) postdonation follow-up, which is important given its association with future likelihood of follow-up. These findings offer the opportunity to tailor and direct educational efforts to increase living donor follow-up, particularly among groups at higher risk of loss to follow-up.