2163 THE SOCIOECONOMIC STATUS OF LIVING UNRELATED RENAL TRANSPLANT DONORS IN THE US IS CONSISTENT WITH ALTRUISTIC MOTIVATION

Abstract

You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery II1 Apr 20102163 THE SOCIOECONOMIC STATUS OF LIVING UNRELATED RENAL TRANSPLANT DONORS IN THE US IS CONSISTENT WITH ALTRUISTIC MOTIVATION John L. Gore, Gabriel M. Danovitch, Arleen Brown, and Jennifer S. Singer John L. GoreJohn L. Gore Seattle, WA More articles by this author , Gabriel M. DanovitchGabriel M. Danovitch Los Angeles, CA More articles by this author , Arleen BrownArleen Brown Los Angeles, CA More articles by this author , and Jennifer S. SingerJennifer S. Singer Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2266AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The National Organ Transplant Act of 1984 prohibited the buying and selling of human organs for transplantation. In other countries, despite similar laws, ecologic evidence of large socioeconomic discrepancies between unrelated donor-recipient pairs suggests the possibility of subversive payment for donated organs. We sought to evaluate the presumption that living unrelated renal transplants (LURTS) in the US are performed for altruistic motives by examining differences in socioeconomic status (SES) in donor-recipient pairs. METHODS We accessed the United Network for Organ Sharing research files to identify adult living donor renal transplant recipients transplanted between 1997-2007. We used a validated composite index (SESI) of the SES characteristics of the ZIP code of residence for each donor and recipient, derived from 2000 US Census Files. An index of 0 represented a patient living in a ZIP code with the median national SES. An index below 0 represented lower SES, and indices above 0 represented higher SES. We compared the SESI of living related and LURT pairs and examined factors associated with a large SESI difference (> 3.0) with logistic regression. RESULTS 51,057 subjects underwent live donor renal transplantation between 1997-2007, of whom 26,978 (53%) lived in higher SES ZIP codes than their donors (p=0.19 compared with related pairs). Although LURT donor-recipient pairs had a higher mean SES index difference (-0.18±3.61 vs 0.04±3.86, respectively), LURT pairs lived in higher SES ZIP codes than their related counterparts (SESI 0.33±3.61 and 0.51±3.74 for LURT donors and recipients; SESI -0.07±3.88 and -0.11±3.85 for related donors and recipients). Being in a LURT pair was associated with higher odds of having a large donor-recipient SESI difference among white recipients (OR 1.50, 95%CI 1.34-1.68, compared with OR 0.99, 95%CI 0.73-1.32 for African Americans, and OR 1.19, 95%CI 0.80-1.75 for Hispanics) and those recipients with at least some college education (OR 0.95, 95%CI 0.41-2.19 for those with less than a high schooled education, OR 1.20, 95%CI 0.98-1.43 for high school-educated recipients, OR 1.54, 95%CI 1.28-1.86 for those with some college, and OR 1.50, 95%CI 1.28-1.75 for those with at least a college degree). CONCLUSIONS We did not identify large discrepancies between the SES of LURT donors and their recipients, suggesting that subversive payment does not confound US LURT. The finding that among certain recipient categories, SES differences tended to be larger requires further evaluation. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e841 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information John L. Gore Seattle, WA More articles by this author Gabriel M. Danovitch Los Angeles, CA More articles by this author Arleen Brown Los Angeles, CA More articles by this author Jennifer S. Singer Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...