Most U.S. adults cannot donate a kidney due to preventable health problems, potential loss of income

There is a shortage of living kidney donors in the United States, but no one has previously examined the general population to see who would be eligible to be donors. To assess the potential US donor pool, researchers led by Anthony Bleyer, MD (Wake Forest Baptist Medical Center) looked at a representative sample of the population and determined the proportion of people who could not be donors because of underlying health conditions. They also determined the number of individuals who fell below the poverty line and therefore might not be able to donate because of financial difficulties related to being away from work during recovery.

The investigators found that 55% of the population would not meet criteria to donate, mostly because of preventable health conditions (19% hypertension, 15% obesity, 11.6% excessive alcohol intake, 12% diabetes). Sixty percent of individuals with an adjusted income of $35,000 per year could not donate due to medical conditions vs. 49% of individuals making >$100,000 per year. If one includes non-US citizenship as criteria for not being able to donate, 68.5% of the US population would not be able to donate.

"The majority of individuals in the US cannot donate, and this is due to preventable health problems in many cases," said Dr. Bleyer. "Lower-income people need transplants more commonly, but individuals from these economic strata are less likely to donate because of more health problems, finances, and immigration status." Dr. Bleyer, a nephrologist and epidemiologist, worked with his son, Anthony Bleyer, Jr., an economics major at Wake Forest University, to develop and carry out the study.

Changes that could directly impact people's ability to donate include: providing compensation for lost work for individuals with lower incomes; addressing immigration issues; and improving the health of the population.