The Change in Living Kidney Donation in Women and Men in the United States (2005–2015): A Population-Based Analysis

Abstract

The factors underlying the decline in living kidney donation in the United States since 2005 must be understood to inform strategies to ensure access to this option for future patients. Population-based estimates provide a better assessment of donation activity than do trends in the number of living donor transplants. Using data from the Scientific Registry of Transplant Recipients and the United States Census, we determined longitudinal changes in living kidney donation between 2005 and 2015, focusing on the effect of sex and income. We used multilevel Poisson models to adjust for differences in age, race, the incidence of ESRD, and geographic factors (including population density, urbanization, and daily commuting). During the study period, the unadjusted rate of donation was 30.1 and 19.3 per million population in women and men, respectively, and the adjusted incidence of donation was 44% higher in women (incidence rate ratio [IRR], 1.44; 95% confidence interval [95% CI], 1.39 to 1.49). The incidence of donation was stable in women (IRR, 0.95; 95% CI, 0.84 to 1.07) but declined in men (IRR, 0.75; 95% CI, 0.68 to 0.83). Income was associated with longitudinal changes in donation in both sexes, yet donation was stable in the highest two population income quartiles in women but only in the highest income quartile in men. In both sexes, living related donations declined, irrespective of income. In conclusion, living donation declined in men but remained stable in women between 2005 and 2015, and income appeared to have a greater effect on living donation in men.

Enrichment of Tc1 cells and T cell resistance to suppression are associated with dysglycemia in the visceral fat in human obesity

“…As shown in table 1, LC were slightly older and prevalently female compared with the overall obese population, which is a consequence of the well-known elevated prevalence of female kidney living donors. 22 Anthropometric parameters confirm the expected elevated BMI in both obese cohorts and show no difference in terms of BMI and fat mass percentage between OB-ND and OB-IFG&D, thus ruling out possible confounders that may interfere with the immunological asset.…”

Disparities in Acceptance of Deceased Donor Kidneys Between the United States and France and Estimated Effects of Increased US Acceptance

“…Over the past decade, the worldwide scarcity of donated kidneys and the decline in the number of living donor transplants in some countries have prompted a variety of efforts to expand the organ supply, such as accepting organs from donors who were older or had comorbidities or other injuries. 5 , 6 , 7 , 8 As new treatment approaches have developed to manage the complications of kidney transplantation, recent studies have suggested that compared with dialysis, even the lowest-quality kidneys lengthen the life span, on average, for transplant recipients. 9 , 10 , 11 …”

Billing for Living Kidney Donor Care: Balancing Cost Recovery, Regulatory Compliance, and Minimized Donor Burden

“…Young adults (aged 18–34 years), men, people of color, the unemployed, single, those with less education, smokers, and those who were normotensive were more likely to lack health insurance. 15 Recent publications demonstrate that the decline in living donation has been more pronounced in lower income groups, 16 leading some to posit that costs associated with donation serve as a barrier or a disincentive.…”