The Role of Race and Socioeconomic Status in Live Donor Kidney Transplant Interest and Evaluation

Introduction: Kidney paired donation (KPD) increases living donor kidney transplantation (LDKT) by allowing non-matching donor-recipient pairs to exchange kidneys.Additionally, off ering the opportunity to participate in KPD to nondirected and Good Samaritan donors can initiate and expand KPD chains, increasing the recipients benefi tting from LDKT.Methods: We retrospectively reviewed LDKTs performed at a single center from 2016-2023 and identifi ed KPDs involving nondirected and Good Samaritan donors.Donor and recipient demographics, clinical characteristics, and the donor's reason for participating in KPD were also reviewed."Nondirected" donors were defi ned as donors without an identifi ed recipient, and "Good Samaritan" donors were defi ned as compatible pairs volunteering to participate in KPD.Results: There were 265 KPDs completed during the study period, with 35 nondirected donors and 54 Good Samaritan donors.Nondirected donors had a median age of 49 years, were most commonly female (60%), and had blood types A (40%) or O (40%; Table ).Good Samaritan donors had a median age of 46.5 years, were mostly female (68.5%), had blood type O (77.8%), and were usually their intended recipient's spouse (38.9%).Chains were a median length of 3 (range: 1-6) pairs.Recipients had an average panel reactive antigen of 7.5% for pairs involving nondirected donors and 17% for Good Samaritan pairs.Blood type O recipients were the most frequent recipients involved in Good Samaritan pairs (72.2%).Conclusion: In our experience, including nondirected and Good Samaritan KPD allowed for a median of 3 donor-recipient pairs, with some chains involving 6 pairs, expanding LDKT access to numerous recipients.Recipients with high PRAs and type O blood received transplants most frequently in these groups.