Kidney360 · 2025
Strategic Innovations to Reduce Disincentives and Increase Living Kidney Donation.
СтатьяНазвание и аннотация: Перевод в очереди
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Leonberg-Yoo Amanda, Redfield Robert, Dunn Ty, Fleming James N, Fonk Janny, Hil Garet, Cooper Matthew
Аннотация
KEY POINTS: Innovations targeting living kidney donor disincentives increase living kidney donation. By addressing known barriers, these programs can expand the donor pool, improve efficiency in donor evaluation, and improve donor experience.
BACKGROUND: While up to 59% of the US population report willingness to donate a kidney, only about 6000 living kidney donations (LKD) occur annually. This study described the use and impact of National Kidney Registry (NKR) programs designed to eliminate disincentives to LKD.
METHODS: This was a retrospective cohort analysis using administrative data records from the NKR, a national database capturing information on potential living kidney donors at 103 transplant centers across the continental United States. Descriptive statistics were used to summarize donor characteristics, program participation, and outcome measures. An interrupted time series was used to analyze changes in registration conversion rates before and after program implementation.
RESULTS: After the implementation of Donor Connect, the registration conversion rate increased from 8.4% immediately preceding implementation to 18.4% by the end of follow-up. At the time of intervention, a statistically significant 8% increase in registration conversion rate was observed (P < 0.001), with an additional 0.3% increase per quarter thereafter (P = 0.017). Remote donors were significantly more likely to live >150 miles from the recipient's transplant center (84% versus 21%); the Remote Donor Program reduced travel burden by 597 [205, 1196] miles. Referral conversion rates were significantly higher for donors living within 50 miles (8.3%) compared with those 51–150 miles (6.5%, P < 0.001) and >150 miles (5.3%, P < 0.003), corresponding to an increased donation odds of 1.31 and 1.62, respectively). Fifty-one percent of donors received cost reimbursement through the Donor Shield program. Donors who participated were more racially diverse and were more likely to reside further from the transplant center.
CONCLUSIONS: This analysis indicates that the outcomes from NKR's programs support the efficacy of disincentive-targeted innovations as a way to increase donation rates by supporting donors and streamlining the donation process. These innovations represent a modern, donor-centered approach to LKD. By addressing known barriers, these programs have the potential to expand the donor pool, improve the efficiency in donor evaluation, and improve the overall donor experience.
PODCAST: This article contains a podcast at https://dts.podtrac.com/redirect.mp3//www.asn-online.org/media/podcast/JASN/2026_02_09_KTS_February2026.mp3
BACKGROUND: While up to 59% of the US population report willingness to donate a kidney, only about 6000 living kidney donations (LKD) occur annually. This study described the use and impact of National Kidney Registry (NKR) programs designed to eliminate disincentives to LKD.
METHODS: This was a retrospective cohort analysis using administrative data records from the NKR, a national database capturing information on potential living kidney donors at 103 transplant centers across the continental United States. Descriptive statistics were used to summarize donor characteristics, program participation, and outcome measures. An interrupted time series was used to analyze changes in registration conversion rates before and after program implementation.
RESULTS: After the implementation of Donor Connect, the registration conversion rate increased from 8.4% immediately preceding implementation to 18.4% by the end of follow-up. At the time of intervention, a statistically significant 8% increase in registration conversion rate was observed (P < 0.001), with an additional 0.3% increase per quarter thereafter (P = 0.017). Remote donors were significantly more likely to live >150 miles from the recipient's transplant center (84% versus 21%); the Remote Donor Program reduced travel burden by 597 [205, 1196] miles. Referral conversion rates were significantly higher for donors living within 50 miles (8.3%) compared with those 51–150 miles (6.5%, P < 0.001) and >150 miles (5.3%, P < 0.003), corresponding to an increased donation odds of 1.31 and 1.62, respectively). Fifty-one percent of donors received cost reimbursement through the Donor Shield program. Donors who participated were more racially diverse and were more likely to reside further from the transplant center.
CONCLUSIONS: This analysis indicates that the outcomes from NKR's programs support the efficacy of disincentive-targeted innovations as a way to increase donation rates by supporting donors and streamlining the donation process. These innovations represent a modern, donor-centered approach to LKD. By addressing known barriers, these programs have the potential to expand the donor pool, improve the efficiency in donor evaluation, and improve the overall donor experience.
PODCAST: This article contains a podcast at https://dts.podtrac.com/redirect.mp3//www.asn-online.org/media/podcast/JASN/2026_02_09_KTS_February2026.mp3