Living kidney donations favor some patient groups: study

April 10 Mon Apr 9, 2012 9:22pm EDT

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April 10 (Reuters) - People in the United States who receive a kidney from a live donor who is not a relative tend to be white, highly educated and live in wealthier neighborhoods, according to a study that calls for wider outreach to promote living donation.

Researchers, whose findings appeared in the Journal of Urology, said the findings demonstrate that financial and educational barriers make it harder for the poor and minorities to give or receive an organ.

"We're not doing enough in this country to remove disincentives to living donation," said Gabriel Danovitch, senior author of the study and director of the kidney and pancreas transplant program at UCLA.

The kidney is one of the few organs a person can give away, yet still lead a healthy life afterwards with one remaining kidney. Since the 1990s, advances in immune-suppression have made it safer to receive an organ from someone who isn't biologically related. Less-invasive surgery techniques also make it easier to donate.

But while medical costs for a live donor are typically covered by health insurance, additional expenses - such as travel, lodging and time off from work - are not.

To see who was most likely to donate, Danovitch and his colleagues looked at information about all 39,000 adult kidney transplants in the United States from 1997 to 2007 that occurred with a live donor. They gathered information on education, race, insurance type, zip code and whether people were related.

Danovitch's group found that kidney donations from non-relatives have become more common, rising from seven percent of live donations in 1997 to 26 percent in 2006.

The vast majority of unrelated donors have an emotional relationship with the patient, such as friends. In a few cases, though, organs came from volunteers with no relationships.

But they found that both unrelated donors and recipients were generally older, likely to live in slightly higher-income neighborhoods than related donors and recipients, and more likely to have a college degree.

Patients with higher socioeconomic status are probably more likely to have access to potential donors who have similar means and resources, the researchers wrote.

"It's not because (people in lower socioeconomic status groups) care about their loved ones any less, but because they can't pay for the flight, the hotel or losing their job," Danovitch told Reuters Health.

Kidney donors typically have to take six weeks off work after the transplant. In addition, informational barriers may explain why recipients of organs from unrelated donors are more likely to have had more education.

Cultural differences may also be a factor, they wrote.

Amber Reeves-Daniel, the medical director of abdominal organ transplant at Wake Forest Baptist Medical Center, said she's seen that African American transplant recipients almost always receive a live donor kidney from a relative.

"I think there's a sense of closeness in the African American family structure of 'we're going to make this work,'" said Reeves-Daniel, who was not involved in the study. "If that doesn't work out, then they say 'I would just get a kidney from a deceased donor.'"

But the number of people waiting for a kidney from a deceased donor greatly outnumbers availability. According to the Organ Procurement and Transplantation Network, 91,000 people are waiting for a kidney in the United States. SOURCE: bit.ly/HXPXRn (Reporting from New York by Kerry Grens at Reuters Health; editing by Elaine Lies and Bob Tourtellotte)

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