Screening for sickle trait among potential live kidney donors: policies and practices in US transplant centers

Sickle cell trait is common in the United States (US) and associated with abnormalities of renal function. Little is known, however, about the potential risk of sickle cell trait to live kidney donors. Using an original questionnaire, we assessed the policies and practices of US renal transplant centers with regard to screening for sickle trait among potential live kidney donors. Fifty-four percent (137/252) of centers responded. Eighty-three percent (113/137) of transplant centers had no policy to screen donors for sickle trait. Thirty-four percent (46/135) of centers reported actually screening donors for sickle trait in practice. Thirty-seven percent (39/105) of centers reported excluding donors with sickle trait always or most of the time. High volume centers (>100 live donor transplants/year) were more likely to screen for sickle trait (Fisher's exact, P = 0.03), but not more likely to exclude potential donors with sickle trait from donating. Most US renal transplant centers do not screen donors for sickle trait. Wide variation is evident in center practice regarding exclusion of donors on the basis of sickle trait. Research into the potential impact of sickle trait on renal function after donation is needed to guide transplant clinicians.