Regional and racial disparities in the use of live non-directed kidney donors

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
D L Segev, R A Montgomery

Abstract

Use of live non-directed donors (LNDDs), or altruistic donors, has increased significantly over the past decade and has fueled debate regarding the ethics and allocation of this new source of live donor kidneys. Three allocation philosophies are currently in use, including donor-centric, recipient-centric and socio-centric models, and our group has also advocated the use of LNDDs in paired donation. However, no universally accepted allocation policy exists, nor does national oversight. To determine allocation patterns resulting from current practice models, we analyzed the 372 LNDD kidney transplants performed in the United States since 1998. Most LNDD transplants occurred at a minority of centers, with only five centers performing over 10, and over 28% of LNDDs traveled out-of-state to donate. Furthermore, a center's use of LNDD kidneys did not correlate with that center's organ shortage. Finally, African Americans were significantly under-represented among recipients who were allocated LNDD kidneys, even after accounting for differences in the racial makeup of the waiting list representing centers using LNDD kidneys. These disparities suggest the need for continued monitoring and discussion of LNDD at a national level. If non...Continue Reading

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Citations

Aug 28, 2010·Clinical Journal of the American Society of Nephrology : CJASN·David A AxelrodKrista L Lentine
May 23, 2012·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Peter P ReeseRoy D Bloom
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Aug 7, 2009·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·S E GentryD L Segev
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Jun 18, 2010·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·G DanovitchB Hippen
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Oct 17, 2017·Clinical Transplantation·Komal KumarDorry L Segev
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Mar 25, 2009·Current Opinion in Organ Transplantation

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