Center variation and risk factors for failure to complete 6 month postdonation follow-up among obese living kidney donors

Academic Article


  • Background. Living kidney donors in the United States who were obese at donation are at increased risk of end-stage renal disease and may benefit from intensive postdonation follow-up. However, they are less likely to have complete follow-up data. Center variation and risk factors for incomplete follow-up are unknown. Methods. Adult living kidney donors with obesity (body mass index, ≥30 kg/m2) at donation reported to the Scientific Registry of Transplant Recipients from January 2005 to July 2015 were included (n = 13 831). Donor characteristics were compared by recorded serum creatinine at 6 months postdonation, and multilevel logistic regression models were used to estimate odds of 6-month creatinine. Results. After adjustment, older age, female sex, and donation after implementation of new center follow-up requirements were associated with higher odds of 6-month creatinine, with lower odds for obese donors with a history of smoking, biologically related donors, and at centers with higher total living donor volume. 23% of variation in recorded 6-month serum creatinine among obese donors was attributed to center (intraclass correlation coefficient: 0.232, P < 0.001). The adjusted probability of 6-month creatinine by center ranged from 10% to 91.5%. Conclusions. Tremendous variation in recorded 6-month postdonation serum creatinine exists among obese living donors, with high volume centers having the lowest probability of follow-up. Moreover, individual-level characteristics such as age, sex, and relationship to recipient were associated with recorded 6-month creatinine. Given increased risk for end-stage renal disease among obese living donors, center-level efforts targeted specifically at increasing postdonation follow-up among obese donors should be developed and implemented.
  • Published In

  • Transplantation  Journal
  • Digital Object Identifier (doi)

    Author List

  • Reed RD; Maclennan PA; Shelton BA; Mustian MN; Blackburn J; Smith SC; Terry KB; Grant R; Sawinski D; Locke JE
  • Start Page

  • 1450
  • End Page

  • 1456
  • Volume

  • 103
  • Issue

  • 7