THE QUEST FOR LIVING-RELATED KIDNEY DONORS FOR CHILDREN WITH END-STAGE RENAL-DISEASE

In a pediatric renal transplant program that actively seeks living-rel ated kidney donors, we achieved a Living donor rate of 55% in 119 chil dren. This approximates the national average but is less than an ideal ized goal. For black children, the Living-donor transplant rate was 41 %, a disconcertingly low rate. in an attempt to define factors that ne gatively affected living-related donor availability, we analyzed our e valuation process by distinct phases (interview, histocompatibility te sting and medical evaluation). We classified our families on the basis of locale (urban, suburban and rural), family unit (two or less paren ts, adult sibs or other relatives presenting at interview) and economi c status (designating only economic-disadvantaged and other), While hi stoincompatibility is predictably a negative factor, the negative impa cts of medical illness in the donor pool, economic disadvantage and si ngle parent family are striking and cumulative, Our data validate the relative success of an aggressive recruitment policy in a patient popu lation that includes many economically disadvantaged families. For ped iatric renal transplant programs with low living-related donor rates, our data should encourage review and possible modification of the dono r recruitment process.