The Socioeconomic Status of Donors and Recipients of Living Unrelated Renal Transplants in the United States

Abstract

We evaluated unrelated living kidney donation in the United States and examined the characteristics of unrelated donor-recipient pairs. We accessed United Network for Organ Sharing files to identify adult living donor renal transplant recipients who received a transplant between 1997 and 2007. We evaluated factors associated with unrelated donation and compared a composite index of the socioeconomic characteristics of donor and recipient ZIP Codes between living unrelated and living related renal transplantation pairs. Spousal pairs were categorized as living related. Of 39,168 adult renal transplant recipients 19% underwent living unrelated renal transplantation. These recipients were more likely white (vs black, Hispanic and other race OR 0.77-0.82, p <0.05) and more highly educated (college vs less than high school OR 0.66, 95% CI 0.54-0.77), and more commonly received care at high volume transplant centers (vs lowest volume centers OR 0.89, 95% CI 0.82-0.95). Living unrelated renal transplantation recipients and donors lived in higher socioeconomic status index ZIP Codes than living related recipients (mean ± SD recipients and donors 0.62 ± 3.74 and 0.44 ± 3.63 vs 0.03 ± 3.85 and 0.10 ± 3.87, respectively, each p <0.001). Living unrelated renal transplantation donors and recipients are generally of higher socioeconomic status than their living related renal transplantation counterparts. There is restricted access to unrelated donors among underserved populations.