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Living-Donor Kidney Transplantation in the Genomics Era: Insights from an International Registry: SA-OR081
Abstract   Peer reviewed

Living-Donor Kidney Transplantation in the Genomics Era: Insights from an International Registry: SA-OR081

Yasar Caliskan, Ozgur Akin Oto, Tarek Alhamad, Halil Yazici, Arzu Velioglu, Abdulmecit Yildiz, Danilo Radunovic, Neetika Garg, Zeynep Ural, Christina Irene Mejia, …
Journal of the American Society of Nephrology, Vol.36(10S)
10/2025
DOI: 10.1681/ASN.202501hwwavg

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Abstract

Background: Genetic considerations are increasingly important in living kidney donor candidate (LKDC) evaluation, especially when LDKCs have a family history of chronic kidney disease (CKD) or are donating to related recipient candidate with suspected genetic etiologies. The LDGen registry captures global practices in LKDC evaluation to inform safer, more consistent genetic screening approaches. Methods: We established a multicenter, cross-sectional REDCap registry to collect de-identified data on LKDCs who (1) underwent genetic testing, (2) had a family history of genetic kidney disease, or (3) were donating to a related intended recipient with CKD of unknown etiology. Participating centers were based in the U.S. and internationally. Data collection occurred between June 2023 and April 2025. Results: 1175 LKDC evaluations were captured from 17 centers, 8 from U.S. and 9 from international centers.(Table 1) The median LKDC age was 47 years, with 55.5% women. U.S. LKDCs were younger (median 39.5 vs. 48 years, p<0.001), more often unrelated to the intended recipient and more likely to be the recipient's child and less likely a parent (p=0.004 and p<0.001, respectively). Among intended recipients, 38.7% had a possible genetic kidney disease and 29.2% had CKD of unknown etiology. Common diagnoses included Alport Syndrome (24.4%), ADPKD (21.8%), FSGS (15.1%), and aHUS (11%). U.S. recipient candidates were older (median 46 vs.32 years, p<0.001), and genetic diagnoses distributions varied significantly by region (p<0.001). (Table 2) Conclusion: This multi-center registry provides a broad view of LKDCs in genetically complex transplant evaluations. Regional differences in donor-recipient candidate demographics and genetic diagnoses highlight the need for tailored approaches to genetic screening and counseling in LKDC evaluations.

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