A multicenter cohort study of potential living kidney donors provides predictors of living kidney donation and non-donation

This multicentre prospective potential living kidney donor cohort study investigated which sociodemographic and other factors predict progression to living kidney donation or donor withdrawal, as little is known on this topic. Data were collected on individuals undergoing living donor assessment at 7 UK hospitals from 01/08/14 to 31/1/16. Multivariable logistic regression was used to explore the relationships between donor and recipient characteristics and likelihood of kidney donation. 805 individuals presented for directed donation to 498 intended recipients. 112 intended recipients received a transplant from a living-donor. Potential donors were less likely to donate if their intended recipient was female rather than male (Odds Ratio (OR) 0.60 (0.38-0.94) p=0.03), a friend rather than relative (OR 0.18 (0.05-0.60) p=0.01), or had renal failure due to a systemic disease rather than another cause (OR 0.41 (0.21-0.80) p=0.01). The most socioeconomically deprived quintile were less likely to donate than the least (OR 0.49 (0.24-1.00) p=0.05), but the trend with deprivation was consistent with chance (p=0.12). Higher BMI was associated with a lower odds of donation (OR per +1kg/m2 0.92 (95% Confidence Interval 0.88-0.96) p<0.001)). Younger potential donors (OR per +1 year 0.97 (0.95-0.98) p<0.001), those of non-white ethnicity (OR 2.98 (1.05-8.44) p=0.04) and friend donors (OR 2.43 (1.31-4.51) p=0.01) were more likely to withdraw from work-up. This is the first UK study of potential living kidney donors to describe predictors of non-donation. Qualitative work with individuals who withdraw might identify possible ways of supporting those who wish to donate but experience difficulties doing so.