Ethnic Disparity in the OPTN Kidney Paired Donation Pilot Program Participation.

Abstract

Background: The Organ Procurement and Transplantation Network (OPTN) Kidney Paired Donation Pilot Program (KPDPP) identifies potential kidney (KI) exchanges by matching living donors (LDs) who cannot donate to their intended candidates with other LD/intended candidate pairs. We examine ethnic minority participation in the KPDPP since its initial match run in October 27, 2010. Data: We analyzed OPTN database for all centers (ctrs) with at least one KPDPP candidate as of 11/30/13. Results: 134 (58%) of 231 LD KI transplant ctrs participated in the KPDPP. The table below compares the ethnic composition of KPDPP candidates with all wait listed candidates at KPDPP ctrs as of 11/30/13, and transplants resulting from KPDPP matching with all transplants at KPDPP centers during 10/27/10-9/30/13.Table: No Caption available.Conclusions: Minority participation in the KPDPP is less than expected from the demographics of the KPDPP center waitlists. Factors such as insurance coverage, awareness of the KPDPP, and socioeconomic status may contribute to this finding. However, the ethnic composition of LD/candidate pairs in the KPDPP was comparable to that of all LD KI transplants nationally (66% White, 13% Black, 14% Hispanic, 5% Asian, and 1% other). Thus, the lower than expected participation of minority candidates in the KPDPP may simply reflect a lower number of suitable minority LDs. Further study is needed to confirm this hypothesis. Increased sample size is needed to determine if participation in the KPDPP results in the number of minority transplants that is proportionate to their participation level.