TY - JOUR
T1 - Care of international living kidney donor candidates in the United States
T2 - A survey of contemporary experience, practice, and challenges
AU - Lentine, Krista L.
AU - Motter, Jennifer D.
AU - Henderson, Macey L.
AU - Hays, Rebecca E.
AU - Shukhman, Ellen
AU - Hunt, Julia
AU - Al Ammary, Fawaz
AU - Kumar, Vineeta
AU - LaPointe Rudow, Dianne
AU - Van Pilsum Rasmussen, Sarah E.
AU - Nishio-Lucar, Angie G.
AU - Schaefer, Heidi M.
AU - Cooper, Matthew
AU - Mandelbrot, Didier A.
N1 - Funding Information:
The authors thank the AST Executive Committee including current chair Christie P. Thomas, the AST Education Committee, and the AST Board of Directors for review and feedback. We also thank survey respondents, including members of the following professional society list-servs: AST LDCOP, AST Kidney Pancreas COP, OPTN/UNOS Transplant Administrators, OPTN/UNOS Kidney Paired Donation, and National Kidney Foundation (NKF) Council of Professional Living Donor Advocates. The authors are volunteer members of the American Society of Transplantation (AST) Living Donor Community of Practice (LDCOP). KLL receives research funding related to living donation from the National Institutes of Health (R01DK120551) is also supported by the Mid-America Transplant/Jane A. Beckman Endowed Chair in Transplantation. DAM receives an unrestricted research grant from the Virginia Lee Cook Foundation. An oral abstract describing portions of this work was presented at the 2019 American Transplant Congress (ATC), June 4, 2019, Boston, MA.
Funding Information:
The authors thank the AST Executive Committee including current chair Christie P. Thomas, the AST Education Committee, and the AST Board of Directors for review and feedback. We also thank survey respondents, including members of the following professional society list‐servs: AST LDCOP, AST Kidney Pancreas COP, OPTN/UNOS Transplant Administrators, OPTN/UNOS Kidney Paired Donation, and National Kidney Foundation (NKF) Council of Professional Living Donor Advocates. The authors are volunteer members of the American Society of Transplantation (AST) Living Donor Community of Practice (LDCOP). KLL receives research funding related to living donation from the National Institutes of Health (R01DK120551) is also supported by the Mid‐America Transplant/Jane A. Beckman Endowed Chair in Transplantation. DAM receives an unrestricted research grant from the Virginia Lee Cook Foundation. An oral abstract describing portions of this work was presented at the 2019 American Transplant Congress (ATC), June 4, 2019, Boston, MA.
Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2020/11
Y1 - 2020/11
N2 - The evaluation and care of non-US citizen, non-US residents who wish to come to the United States to serve as international living kidney donors (ILKDs) can pose unique challenges. We surveyed US transplant programs to better understand practices related to ILKD care. We distributed the survey by email and professional society list-servs (Fall 2018, assessing 2017 experience). Eighty-five programs responded (36.8% program response rate), of which 80 considered ILKD candidates. Only 18 programs had written protocols for ILKD evaluation. Programs had a median of 3 (range: 0,75) ILKD candidates who initiated contact during the year, from origin countries spanning 6 continents. Fewer (median: 1, range: 0,25) were approved for donation. Program-reported reasons for not completing ILKD evaluations included visa barriers (58.6%), inability to complete evaluation (34.3%), concerns regarding follow-up (31.4%) or other healthcare access (28.6%), and financial impacts (21.4%). Programs that did not evaluate ILKDs reported similar concerns. Staff time required to evaluate ILKDs was estimated as 1.5-to-3-times (47.9%) or >3-times (32.9%) that needed for domestic candidates. Among programs accepting ILKDs, on average 55% reported successful completion of 1-year follow-up. ILKD evaluation is a resource-intensive process with variable outcomes. Planning and commitment are necessary to care for this unique candidate group.
AB - The evaluation and care of non-US citizen, non-US residents who wish to come to the United States to serve as international living kidney donors (ILKDs) can pose unique challenges. We surveyed US transplant programs to better understand practices related to ILKD care. We distributed the survey by email and professional society list-servs (Fall 2018, assessing 2017 experience). Eighty-five programs responded (36.8% program response rate), of which 80 considered ILKD candidates. Only 18 programs had written protocols for ILKD evaluation. Programs had a median of 3 (range: 0,75) ILKD candidates who initiated contact during the year, from origin countries spanning 6 continents. Fewer (median: 1, range: 0,25) were approved for donation. Program-reported reasons for not completing ILKD evaluations included visa barriers (58.6%), inability to complete evaluation (34.3%), concerns regarding follow-up (31.4%) or other healthcare access (28.6%), and financial impacts (21.4%). Programs that did not evaluate ILKDs reported similar concerns. Staff time required to evaluate ILKDs was estimated as 1.5-to-3-times (47.9%) or >3-times (32.9%) that needed for domestic candidates. Among programs accepting ILKDs, on average 55% reported successful completion of 1-year follow-up. ILKD evaluation is a resource-intensive process with variable outcomes. Planning and commitment are necessary to care for this unique candidate group.
KW - international donor
KW - living donor kidney transplantation
KW - living kidney donation
KW - logistics
KW - practices
KW - survey
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U2 - 10.1111/ctr.14064
DO - 10.1111/ctr.14064
M3 - Article
C2 - 32808320
AN - SCOPUS:85092672582
SN - 0902-0063
VL - 34
JO - Clinical Transplantation
JF - Clinical Transplantation
IS - 11
M1 - e14064
ER -