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Medicine and Health Sciences | Nephrology


Because of the benefits of preemptive living donor (LD) transplant, the desire for LD is rising. However, in the last decade, there has been no increase in LD in the U.S, possibility due to older donor candidate population leading to increased denial rates. We previously studied denial rates and cause for denial for donor candidates between 2009 and 2011. We herein present for comparison causes for denial for donor candidates between 8/2012 and 6/2015. During the interval, our acceptance criteria have not changed. Results: Between August 2012 and June 2015, we evaluated 644 potential living donors: 2012=88, 2013=222, 2014=220, 2015 (Jan-June) =114. Of these, 31% of candidates were denied: 26% for medical reasons, 5% for psychosocial reasons. Mean age of approved candidates = 41 (range: 18-75); average denied = 43 (range, 18-72). To compare, between 2009-2011, 36% candidates were denied (32% medical, 4% psychosocial). The mean age for approved candidates = 40, while denied candidates mean age = 47 (range, 18-64). Current candidates most common medical denials reasons were obesity and suboptimal kidney anatomy, although the distribution of reasons varies by age cohort. Historical group (2009-2011): most common medical denials were hypertension and poor kidney function. Psychosocial denial reasons included: mental illness, lack of support and substance abuse. Conclusion: Over an interval of 6.5 years, the rate of donor candidate denial at our center has not changed. Overall, there has been a change in major reasons for denial; importantly, reasons for denial vary by donor age.


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