Why in Spain the Kidney Altruistic Donation Rate is Lower that of Other Countries of our Environment?

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Abstract

Introduction

Spain has a national altruistic living kidney donation program since 2010.

Introduction

In this program the evaluation of each candidate is structured in three consecutive steps, which must be overcome to advance the process:

Introduction

1. Initial semi-structured telephone interview from the ONT.

Introduction

2. Evaluation in a hospital with a kidney transplant program.

Introduction

3. Evaluation in a hospital with crossover kidney exchange program.

Introduction

The real effectiveness of the Spanish program is lower than that published by neighboring countries such as: UK, Netherlands and USA.

Objective

Describe the characteristics of potential candidates for altruistic renal donation in Spain and the causes of dismissal at each level of evaluation.

Objective

Know the characteristics of those candidates who finally managed to donate their kidney.

Method

Retrospective, descriptive study of the epidemiological, motivational and pathological characteristics of all candidates for altruistic kidney donation in Spain, between January 2010 and December 2016.

Resulted

182 people showed interest in the altruistic donation, 67% of these (n = 123) was rejected after the initial interview conducted from the ONT, and the main reasons were: Medical contraindication (35%) and loss of interest after receiving specific information about the process (27%).

Resulted

The candidates who passed this first interview (n = 59), had an average age of 51.3 years, they were Spanish (88%), with secondary or higher education (65%, n = 40), active in work (62%, n = 47), without a current partner (62%, n = 45), with children (56%, n = 46) and 100% (n = 44) recognized an altruistic life course (39% were blood donors; 29% NGO volunteers, 22% bone marrow donors, 20% organ donors after death).

Resulted

The main motivation recognized was: "Awareness of the need for society" (32%) and "Improve the quality of life of other people" (23%).

Resulted

In the first hospital evaluation, 39% (n=23) were dismissed, mainly as a result of detected medical and/or psychiatric contraindications (78%).

Resulted

In the second hospital evaluation, 44% candidates were discarded (n=16), of which 65% were also due to medical and/or psychiatric contraindications.

Resulted

Finally, 13 of these candidates (7% total) satisfactorily surpassed the three levels of evaluation: 8 men and 5 women, with an average age of 49 years, with no medical history except overweight (2) and obesity (1).

Conclusion

People, who present themselves as candidates for an altruistic kidney donation, have a history of helping others and a strong motivation towards donation.

Conclusion

A significant number of candidates are rejected due to medical contraindications.

Conclusion

It is necessary to perform an audit of medical contraindications to assess whether they are adequate.

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