Research Feature: The efficiency of living kidney donor evaluation

Did you know?

  • In 2019, 534 healthy Canadians donated a kidney to someone on the transplant waitlist, including 88 who donated via the paired kidney exchange program. (Source)
  • In Canada, 30% of all kidney transplants are made possible by a living kidney donor. (Source)

Over the last several years the research group of Dr. Amit Garg has produced a body of work focused on improving the efficiency of donor evaluation, including understanding how long the evaluation is and how to improve the evaluation. Since 2018, the eight publications below have resulted from this work, done as part of a CanSOLVE-CKD project.

“For living donor candidate evaluations in Canada we now better understand: how long it takes, how much it costs, solutions proposed in literature, how patient and healthcare outcomes may improve with a faster evaluation, benefits of evaluating multiple living kidney donor candidates simultaneously, and indicators that can be used to measure how  efficiently a transplant centre evaluates potential living kidney donors.
We now need to test solutions to improve the efficiency and satisfaction of the donor evaluation process. This includes strategies such as pilot-testing a one-day donor evaluation.”

-Dr. Kyla Naylor, Staff Scientist at ICES and Adjunct Research Professor at Western University


The efficiency of evaluating candidates for living kidney donation: a scoping review
Habbous et al (2018). Transplantation (LINK)

This paper reviews the literature on key factors that affect the efficiency of evaluating living kidney donors, and identifies knowledge gaps in how inefficient donor evaluation processes impact healthcare costs and health outcomes for patients.

Healthcare Costs for the Evaluation, Surgery, and Follow-Up Care of Living Kidney Donors
Habbous S et al. (2018)  Transplantation (LINK).

This paper estimates the costs of living kidney donation, including donor evaluation, surgery, and follow-up in 5 Ontario transplant centers over a 10-year period.

Initiating Maintenance Dialysis Before Living Kidney Donor Transplantation When a Donor Candidate Evaluation Is Well Underway
Habbous et al. (2018), Transplantation (LINK).

This study found that many patients with kidney failure initiate dialysis even if the evaluation of their living donor is well underway, and suggests that improving the efficiency of donor evaluation could improve outcomes for both donor and recipient, and lower healthcare costs.

Potential implications of a more timely living kidney donor evaluation
Habbous et al. (2018), American Journal of Transplantion (LINK)

This work estimated that shortening the time taken for living kidney donor evaluation by 3 months could save the Ontario health care system $2.7M per year.

Duration of Living Kidney Transplant Donor Evaluations: Findings From 2 Multicenter Cohort Studies
Habbous et al. (2018), American Journal of Kidney Diseases (LINK).

This paper determined the time taken for donor evaluation in over 20 Canadian and Australian transplant centers, and associated specific factors with centers that had longer evaluation times.

Can Split Renal Volume Assessment by Computed Tomography Replace Nuclear Split Renal Function in Living Kidney Donor Evaluations? A Systematic Review and Meta-Analysis
Habbous et al. (2019), Canadian Journal of Kidney Health and Disease (LINK).

This study examined one potential strategy to safely reduce the number of tests required of living kidney donors during their evaluation.

A RAND-Modified Delphi on Key Indicators to Measure the Efficiency of Living Kidney Donor Candidate Evaluations
Habbous et al. (2020), Clinical Journal of American Society of Nephrology (LINK).

 This work identified a set of indicators that can assist transplant centers in effectively measuring the efficiency of their living kidney donor evaluation process.

Evaluating multiple living kidney donor candidates simultaneously is more cost-effective than sequentially
Habbous et al. (2020), Kidney International (LINK).

 This work demonstrates that evaluating multiple living donor candidates at the same time can save healthcare costs overall, because the transplant can happen more quickly, saving dialysis costs.

You can find Amit and Kyla on Twitter (@AmitXGarg and @kyla_naylor) and as a part of CDTRP Research Theme 1: Create a culture of donation.

Do not miss Kyla’s presentation alongside PFD partner Susan Mckenzie on the next Theme 1 meeting call on Friday, October 22 at 9am PT | 10am MT | noon ET | 1pm AT.