{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T23:44:13Z","timestamp":1773013453246,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In the United States, a severe organ shortage precipitates an extensive transplant waitlist. Living donor kidneys are functionally superior to those from deceased donors and offer an alternative to close the supply\u2010demand gap.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of 2147 patients who self\u2010referred to begin the living kidney donation workup process at our center between June 1, 2012, and October 1, 2023 was conducted with subsequent statistical analysis of gathered data. National Kidney Registry (NKR) affiliation began February 1, 2018, and the pre\u2010 and post\u2010NKR periods were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The pre\u2010NKR period saw 894 total referrals (42%) compared to 1253 post\u2010NKR (58%). Post\u2010NKR donors increased to 89 from 47 pre\u2010NKR with similar times between stages except for a significantly shorter referral\u2010to\u2010lab review post\u2010NKR (47.0 vs. 56.5 days,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). A notable decrease in referrals from Indigenous Peoples was observed (121 [14%] to 93 [7%],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) yet donations increased (2 [4%] to 7 [8%],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.042). Donors originating from South Dakota increased (26\u201354,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.59) post\u2010NKR, and significantly more patients pursued nondirected referral (25 [3%] vs. 173 [14%],\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01) with similar proportions following through with donation. Reasons for dropout during the process were similar between the periods, yet quantitative distributions differed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NKR affiliation coincided with encouraging results, in many cases similar to broad national trends, attesting to improved connectivity and impact on focal population groups.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70315","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T18:16:57Z","timestamp":1757441817000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A 12\u2010Year Analysis of Equity and Efficiency in Living Kidney Donation at a Rural American Center"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-5300-1571","authenticated-orcid":false,"given":"Benjamin","family":"Limburg","sequence":"first","affiliation":[{"name":"Sanford School of Medicine University of South Dakota  Sioux Falls South Dakota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5360-9771","authenticated-orcid":false,"given":"Kaleb","family":"Dobbs","sequence":"additional","affiliation":[{"name":"Sanford School of Medicine University of South Dakota  Sioux Falls South Dakota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2343-9493","authenticated-orcid":false,"given":"Els","family":"Reuvekamp","sequence":"additional","affiliation":[{"name":"Sanford School of Medicine University of South Dakota  Sioux Falls South Dakota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sujit Vijay","family":"Sakpal","sequence":"additional","affiliation":[{"name":"Avera Medical Group Transplant &amp; Liver Surgery Avera McKennan Hospital &amp; University Health Center  Sioux Falls South Dakota USA"},{"name":"Department of Surgery &amp; Internal Medicine University of South Dakota Sanford School of Medicine  Sioux Falls South Dakota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Data \u2013 OPTN accessed Feb 3 2025 https:\/\/optn.transplant.hrsa.gov\/data\/."},{"key":"e_1_2_8_3_1","unstructured":"Kidney Donation Risks \u2013 National Kidney Registry accessed Feb 3 2025 https:\/\/www.kidneyregistry.com\/for\u2010donors\/i\u2010want\u2010to\u2010learn\u2010more\u2010about\u2010living\u2010kidney\u2010donation\/kidney\u2010donation\u2010risks\/#:~:text=More%20than%206%2C418%20living%20donors it%20is%20not%20without%20risks."},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.16502"},{"key":"e_1_2_8_5_1","article-title":"Does Kidney Transplantation with Deceased or Living Donor Affect Graft Survival?","volume":"6","author":"Nemati E.","year":"2018","journal-title":"Nephro\u2010Urology Monthly"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000004357"},{"key":"e_1_2_8_7_1","unstructured":"South Dakota \u2013 2021 \u2013 III.B. Overview of the State accessed Feb 3 2025 https:\/\/mchb.tvisdata.hrsa.gov\/Narratives\/Overview\/9bff16ac\u2010d4aa\u20104bff\u2010a6d8\u20106739f77b5426."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.545"},{"key":"e_1_2_8_9_1","unstructured":"DP05: ACS Demographic and Housing Estimates \u2013 United States Census Bureau accessed Feb 3 2025 https:\/\/data.census.gov\/table\/ACSDP1Y2023.DP05?g=040XX00US46."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-024671"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.7182\/prtr.1.8.3.f89854842113un43"},{"key":"e_1_2_8_12_1","unstructured":"M.GutierrezandA. T.Bennett Celebrating Native American Heritage Month: Empowering Native Communities through Digital Equity National Telecommunications and Information Administration(2024) accessed Feb 9 2025 https:\/\/www.ntia.gov\/blog\/2024\/celebrating\u2010native\u2010american\u2010heritage\u2010month\u2010empowering\u2010native\u2010communities\u2010through\u2010digital\u2010equity#:~:text=According%20to%20the%20Federal%20Communications of%20the%20overall%20U.S.%20population."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04211.x"},{"key":"e_1_2_8_14_1","unstructured":"OPTN\/SRTR 2020 Annual Data Report: Living Donor accessed Feb 9 2025 https:\/\/srtr.transplant.hrsa.gov\/ADR\/Chapter?name=LivingDonor&year=2020#:~:text=Candidates%20with%20college%20or%20postgraduate candidates%20(Figure%20LD%2016)."},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.13015"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-023-01755-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000428"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/2013.jamasurg.25"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.34067\/KID.0003212020"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.procs.2025.03.225"}],"container-title":["Clinical Transplantation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ctr.70315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ctr.70315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:27:57Z","timestamp":1773008877000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ctr.70315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":19,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/ctr.70315"],"URL":"https:\/\/doi.org\/10.1111\/ctr.70315","archive":["Portico"],"relation":{},"ISSN":["0902-0063","1399-0012"],"issn-type":[{"value":"0902-0063","type":"print"},{"value":"1399-0012","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70315"}}