Abstract

Living kidney donors have emerged as the best option to overcome the severe shortage of transplantable kidneys. A growing number of these living donor kidneys come from anonymous altruistic donors who are not related to the recipients according to UNOS data. This study examines the process of anonymous altruistic kidney donation and identifies barriers and variance in transplant center practices. Using a mock patient caller, 73 transplant centers were contacted and asked about the process of altruistic anonymous kidney donation and then scored using objective and subjective metrics. We use SRTR data to measure the relationship between altruistic donation and transplant volume, competition, and quality and scored responses as subjective (how nice and responsive the person was) and objective (follow up, etc). Sixty-seven of the 73 transplant centers contacted perform anonymous altruistic donations. The mean subjective score was 53.60, and the mean objective score was 53.88. A majority of centers were willing or highly willing to answer questions (56.8%), but more than half (56.8%) answered them inadequately or used jargon. Models including a center's characteristics (competition, waitlist and transplant volume and quality measures) were capable of significantly predicting which programs would have higher objective (C-stat 0.846) and subjective scores (C-stat 0.749). The process for anonymous altruistic donation is highly variable by center. These inconsistencies in practice can potentially lead to confusion, public misperception and discourage motivated individuals from donation.

Authors and Affiliations