title: Living Donor Kidney Transplantation: Overcoming Disparities in Live Kidney Donation in the US--Recommendations from a Consensus Conference.
abstract: Despite its superior outcomes relative to chronic dialysis and deceased donor kidney transplantation, live donor kidney transplantation (LDKT) is less likely to occur in minorities, older adults, and poor patients than in those who are white, younger, and have higher household income. In addition, there is considerable geographic variability in LDKT rates. Concomitantly, in recent years, the rate of living kidney donation (LKD) has stopped increasing and is declining, after decades of consistent growth. Particularly noteworthy is the decline in LKD among black, younger, male, and lower-income adults. The Live Donor Community of Practice within the American Society of Transplantation, with financial support from 10 other organizations, held a Consensus Conference on Best Practices in Live Kidney Donation in June 2014. The purpose of this meeting was to identify LKD best practices and knowledge gaps that might influence LDKT, with a focus on patient and donor education, evaluation efficiencies, disparities, and systemic barriers to LKD. In this article, we discuss trends in LDKT/LKD and emerging novel strategies for attenuating disparities, and we offer specific recommendations for future clinical practice, education, research, and policy from the Consensus Conference Workgroup focused on disparities.
authors.affiliation: Transplant Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts;
authors.forename: James R
authors.initials: JR
authors.lastname: Rodrigue
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, South Carolina;
authors.forename: Abby Swanson
authors.initials: AS
authors.lastname: Kazley
authors.affiliation: Transplant Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin; and.
authors.forename: Didier A
authors.initials: DA
authors.lastname: Mandelbrot
authors.affiliation: Transplant Center, University of Wisconsin Hospital and Clinics, Madison, Wisconsin; and.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hays
authors.affiliation: Recanati Miller Transplantation Institute, Mount Sinai Medical Center, New York, New York.
authors.forename: Dianne
authors.initials: D
authors.lastname: LaPointe Rudow
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, South Carolina; baligap@musc.edu.
authors.forename: Prabhakar
authors.initials: P
authors.lastname: Baliga
mesh_terms: D001741:Black or African American; D000367:Age Factors; D032921:Consensus; D054521:Cultural Competency; D019317:Evidence-Based Medicine; D006297:Health Services Accessibility; D054625:Healthcare Disparities; D006801:Humans; D007182:Income; D016030:Kidney Transplantation / Q000191:economics / Q000639:trends; D019520:Living Donors / Q000193:education; D008913:Minority Groups; D010353:Patient Education as Topic / Q000592:standards; D012106:Research; D012737:Sex Factors; D066027:Transplant Recipients / Q000193:education; D014481:United States
keywords: kidney transplantation; organ transplant; renal transplantation