Abstract
Genetic Testing and Living Kidney Donor Candidate Decision-Making: Lessons from a Multicenter International Registry: SA-PO0612
Journal of the American Society of Nephrology, Vol.36(10S)
10/2025
DOI: 10.1681/ASN.202565f6q080
Abstract
Background:
Genetic testing is increasingly used in evaluating living kidney donor candidates (LKDCs), though clear guidelines are lacking. We present findings from LDGen registry designed to capture evolving genetic testing practices during LKDC evaluation.
Methods:
LDGen is a cross-sectional, REDCap registry (June 2023-April 2025) collecting de-identified data on LKDCs who (1) underwent genetic testing (2) had family history of genetic kidney disease or (3) were being evaluated to donate to a related intended recipient with kidney disease of unknown etiology. Positive results included pathogenic, likely pathogenic, and clinically relevant VUS.
Results:
Among 1175 LKDC evaluations from 17 transplant centers (8 U.S., 9 international), 21% underwent genetic testing (Fig. 1). Testing was done first in intended recipients in 13% and in LKDCs only in 7%. Overall, 4% of LKDCs were not accepted, with higher declination rates in U.S. centers than international ones (16% vs. 2%, p<0.001). Genetic testing accounted for 50% of all declinations (Fig. 2). Key predictors of LKDC declination included evaluation at U.S. center (aOR=5.65, p<0.001), younger age (aOR=0.95, p<0.001), and whether any genetic testing was performed (aOR=10.85, p<0.001). In 241 LKDC evaluations with genetic testing, older donor age was associated with lower odds of declination, while a positive genetic test result increased the odds of declination (aOR=6.23, p<0.001).
Conclusion:
The LDGen registry reveals substantial international variability in genetic testing practices among LD evaluations. Positive genetic findings, younger LKDC age, and the use of testing were associated with increased likelihood of LKDC declination. These results underscore the need for standardized protocols and equitable access to genetic counseling in LKDC evaluation.
Details
- Title: Subtitle
- Genetic Testing and Living Kidney Donor Candidate Decision-Making: Lessons from a Multicenter International Registry: SA-PO0612
- Creators
- Yasar Caliskan - Saint Louis UniversityOzgur Akin Oto - Istanbul UniversityTarek Alhamad - Washington University in St. LouisHalil Yazici - Istanbul Yeni Yüzyıl UniversityArzu Velioglu - Marmara UniversityAbdulmecit Yildiz - Bursa Uludağ Üni̇versi̇tesi̇Danilo Radunovic - Klinički Centar Crne GoreNeetika Garg - University of Wisconsin SystemZeynep Ural - Gazi UniversityChristina Irene Mejia - Johns Hopkins UniversityOndrej Viklicky - Institute of Clinical and Experimental MedicineArksarapuk Jittirat - University Hospitals Cleveland Medical CenterSultan Ozkurt - Eskişehir Osmangazi UniversityReem Daloul - Allegheny Health NetworkHernando Trujillo - Hospital Universitario 12 De OctubreKarim Soliman - Medical University of South CarolinaAydin Turkmen - Istanbul UniversityBrian Lee - Seton Medical CenterChristie P. Thomas - University of IowaRoslyn B. Mannon - University of Nebraska Medical CenterKrista L. Lentine - Saint Louis University
- Resource Type
- Abstract
- Publication Details
- Journal of the American Society of Nephrology, Vol.36(10S)
- DOI
- 10.1681/ASN.202565f6q080
- ISSN
- 1046-6673
- eISSN
- 1533-3450
- Language
- English
- Date published
- 10/2025
- Academic Unit
- Stead Family Department of Pediatrics; Obstetrics and Gynecology; Nephrology; Internal Medicine
- Record Identifier
- 9985019036402771
Metrics
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