The Socioeconomic Status of Donors and Recipients of Living Unrelated Renal Transplants in the United States

Purpose: We evaluated unrelated living kidney donation in the United States and examined the characteristics of unrelated donor-recipient pairs. Materials and Methods: We accessed United Network for Organ Sharing files to identify adult living donor renal transplant recipients who received a transplant between 1997 and 2007. We evaluated factors associated with unrelated donation and compared a composite index of the socioeconomic characteristics of donor and recipient ZIP Codes between living unrelated and living related renal transplantation pairs. Spousal pairs were categorized as living related. Results: Of 39,168 adult renal transplant recipients 19% underwent living unrelated renal transplantation. These recipients were more likely white (vs black, Hispanic and other race OR 0.77-0.82, p < 0.05) and more highly educated (college vs less than high school OR 0.66, 95% CI 0.54-0.77), and more commonly received care at high volume transplant centers (vs lowest volume centers OR 0.89, 95% CI 0.82-0.95). Living unrelated renal transplantation recipients and donors lived in higher socioeconomic status index ZIP Codes than living related recipients (mean +/- SD recipients and donors 0.62 +/- 3.74 and 0.44 +/- 3.63 vs 0.03 +/- 3.85 and 0.10 +/- 3.87, respectively, each p < 0.001). Conclusions: Living unrelated renal transplantation donors and recipients are generally of higher socioeconomic status than their living related renal transplantation counterparts. There is restricted access to unrelated donors among underserved populations.