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Living Donors on the Transplant Waiting List

A Bioethics Forum essay entitled “We need a registry for living kidney donors” contained this important information:

…between 1993 and 2005, at least 102 (0.2%) of the 63,000 living kidney donors in the United States developed kidney failure and were listed for transplant themselves.

..the data [is] incomplete. The number of individuals on the transplant waiting list represents only a fraction of the total who have end stage renal disease (ESRD), and we have no reason to suspect that all former donors with ESRD are on the list. Some are excluded from transplantation because of comorbidities; others have seriously impaired kidney function or other health conditions but do not yet qualify for dialysis or transplant.

…data from Sweden (published in Transplantation in 2006), where researchers found that six (0.5%) of 1,112 living kidney donors had developed ESRD – a rate 2.5 times what Gibney and colleagues found.

The Gibney article shows that of the 102 U.S. living kidney donors who were listed for transplant postdonation, most were male (64%) and the average age was fifty. (In Sweden, 83% were male and the average age was fifty-three.)

…in the United States…44% were African Americans, and 12% were Hispanic. Since only 14% of all living donors are African Americans, African American donors appear to run an increased risk of ESRD, which mirrors the increased frequency of ESRD in the African American community at large.

What is disconcerting, however, is that though the average length of time between donation and kidney failure was over fifteen years, ten U.S. donors – nine of them African American – were listed for transplant less than five years after donating. This is troubling because the screening process has been thought to ensure that donors are healthier than the average citizen.

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