title: Predictors of candidate maturation among potential living donors.
abstract: The shortage of deceased donor allografts and improved outcomes in partial organ transplantation have led to widespread application of adult-to-adult living donor liver transplantation. Donor selection limits overall utilization of this technique and predictors of candidate maturation have been inadequately studied to date. We therefore collected data on 237 consecutive potential donors including their age, sex, ethnicity, relationship to the recipient, education, employment and religious beliefs and practices. Of these 237 candidates, 91 (38%) were excluded for medical and psychosocial reasons, 53 (22%) withdrew from the process predonation and 93 (39%) underwent partial liver donation. In multivariate analyses, the relationship between the donor and the recipient was highly predictive of successful donation. For pediatric recipients, no parents voluntarily withdrew from the evaluation process. For adult recipients, spouses are the most likely to donate, followed by parents, children and siblings. Additional predictors for donation included self-description as religious but not regularly practicing, part-time employment and higher education. Race, ethnicity, gender and age did not predict donation in multivariate analysis. Further understanding of the complex decision to donate may improve donation rates as well as permit more efficient and cost-effective donor evaluation strategies.
authors.affiliation: Center for Liver Disease and Transplantation, New York Presbyterian Hospital, New York, NY, USA.
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Verna
authors.forename: Kristel H
authors.initials: KH
authors.lastname: Hunt
authors.forename: John F
authors.initials: JF
authors.lastname: Renz
authors.forename: Dianne LaPointe
authors.initials: DL
authors.lastname: Rudow
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hafliger
authors.forename: Lorna M
authors.initials: LM
authors.lastname: Dove
authors.forename: Milan
authors.initials: M
authors.lastname: Kinkhabwala
authors.forename: Jean C
authors.initials: JC
authors.lastname: Emond
authors.forename: Robert S
authors.initials: RS
authors.lastname: Brown
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D003657:Decision Making; D003661:Decision Support Techniques; D005190:Family; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016377:Organ Transplantation / Q000379:methods*; D018579:Patient Selection; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods; D009927:Tissue and Organ Procurement / Q000379:methods; D016896:Treatment Outcome; D014850:Waiting Lists