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To the Editor:

We greatly appreciate the comments submitted by Daniel-Reeves and Freedman concerning our recent publication (1). Additional information specifically pertaining to African American (AA) child-to-parent donation is a very important question; however, the number of living kidney donors (LKDs) falling into this category was too small for a comprehensive analysis. This sub-analysis, if it could be performed in a statistically valid manner, would be extremely beneficial given the prevalence of end-stage renal disease (ESRD) in the AA community.

We were also very interested in the same question, but knowing the limitations of the data, we stated in the discussion section of our paper: “The finding that Black LKDs were younger than White LKDs could reflect a higher prevalence of hypertension or other medical conditions that precluded kidney donation in older Black donor candidates. Thus, the younger age of Black donors could potentially increase their risk for ESRD because an older donor candidate would have had more time to develop conditions that would preclude donation. However, the higher rate of ESRD does not appear to be because of longer postdonation duration as the median time from donation to ESRD was similar between White and Black donors (11 and 9.6 years, respectively)” (2).

Additional data is needed to clarify the true risk of ESRD for AA child-to-parent living kidney donors. The fact that so few LKDs developed ESRD is encouraging. Moreover, there was not a preponderance of these donors who were in the AA child-to-parent category. Finally, we continue to stress that a complete donor evaluation be coupled with education of the donor as well as close postdonation follow-up.

Disclosure

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  2. Disclosure
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The authors of this manuscript have no conflicts of interest to disclose as described by the American Journal of Transplantation.

Acknowledgments

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This work was performed for the Organ Procurement and Transplantation Network (OPTN) Minority Affairs Committee and was supported wholly or in part by Health Resources and Services Administration (HRSA) contract 234–2005-370011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of HHS, nor does mention of trade names, commercial products or organizations imply endorsement by the U.S. Government.

References

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