title: Racial differences in outcomes of the evaluation of potential live kidney donors: a retrospective cohort study.
abstract: BACKGROUND
  In the USA, the lower rate of live donor kidney transplant among Black transplant candidates may stem from lower rates of donation among potential live donors who are Black. We determined whether outcomes of the evaluation of potential live kidney donors varied according to the potential donors' demographic characteristics.
  
  
  METHODS
  We performed a single-center, retrospective observational cohort study of 1,179 potential live kidney donors, who came forward between 2000 and 2007. Potential donors' intended recipients were first-time transplant recipients who were evaluated between 2000 and 2005.
  
  
  RESULTS
  There were 268 (22.7%) potential live kidney donors who were Black, of whom 93.7% were recruited by Black transplant candidates. Donor outcomes included actual donation (38.3%), exclusion due to blood group or crossmatch incompatibility (20.4%), exclusion due to medical contraindication to donation (13.7%), and lack of further donor interest (11.2%). Black (vs. non-Black) potential donors were less likely to actually donate (27.2 vs. 41.6%, p < 0.001). Black potential donors were more likely to stop pursuing live donation (p = 0.047) or be excluded from donation for medical reasons (p = 0.008) or blood group or crossmatch incompatibility (p = 0.01). These racial differences persisted in a multivariable multinomial logistic regression model of factors associated with outcomes of the donor evaluation.
  
  
  CONCLUSIONS
  Potential live kidney donors who are Black are less likely to actually donate. Future studies should determine whether paired exchange and desensitization programs decrease these racial differences and why Black potential donors appear more likely to stop pursuing live donation.
authors.affiliation: Renal and Pancreas Transplant Division and Division of Nephrology, Department of Medicine, Saint Barnabas Medical Center, Livingston, NJ 07039, USA. fweng @ barnabashealth.org
authors.forename: Francis L
authors.initials: FL
authors.lastname: Weng
authors.forename: Navdeep
authors.initials: N
authors.lastname: Dhillon
authors.forename: Yong
authors.initials: Y
authors.lastname: Lin
authors.forename: Shamkant
authors.initials: S
authors.lastname: Mulgaonkar
authors.forename: Anup M
authors.initials: AM
authors.lastname: Patel
mesh_terms: D000328:Adult; D001741:Black or African American; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000706:statistics & numerical data*; D019520:Living Donors / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies