Factors that preclude the conclusion of a kidney transplant protocol from a living donor

A kidney transplant (KT) is a renal replacement therapy that offers greater survival and quality of life; however, it is not always successfully completed due to social, physical, medical, immunological factors, or lack of adherence.

This retrospective, analytical, longitudinal study included patients in the KT protocol from a living donor between May 2021 and November 2022. Factors preventing completion were evaluated. Comparative analyses and cumulative incidence curves were used to assess time to protocol completion or discontinuation. The analysis was performed using IBM SPSS Statistics, version 26 (IBM Corp., USA).

Among 240 donor-recipient pairs, 116 (48.3%) successfully completed KT, whereas 124 (51.6%) did not. Reasons for non-completion included medical causes (59/124; 47.6%), immunological incompatibility (28/124; 22.6%), psychosocial factors (14/124; 11.3%), and other causes (23/124; 18.5%). The median time to protocol acceptance or discontinuation was 151 days (IQR 115-186). Among individuals who ultimately underwent KT, the median completion time was also 151 days (IQR 109-231).

Medical conditions were the predominant barriers to completing living-donor KT protocols, followed by immunologic and psychosocial factors. Streamlining medical assessments, implementing early immunologic screening, and reinforcing psychosocial support may enhance protocol completion rates.