Background: Kidney transplantation from living donors (LD) has stagnated in many countries. This study aimed to check whether correction of LD selection practice could increase the number of kidney transplantations.Methods: From January 2003 to December 2012, 241 potential adult LD were evaluated in our hospital. Outcome (mortality and end-stage renal disease-ESRD) of accepted LD (182) was compared with unaccepted (59) donors.Results: Mortality of LD was comparable with that for the standardized Serbian population (SMR = 1.104; 95% CI (0.730–1.606). Among evaluated potential LD, almost every fourth had been unaccepted, but reasons were modifiable in 42.4% of them. In pre-donation period unaccepted donors were significantly older, measured glomerular filtration rate was lower, with higher 15-year and lifelong projected ESRD risks than accepted donors. Despite this, ten years outcome of both groups LD was similar: none of LD developed ESRD, 9.8% of accepted and 11.8% of unaccepted LD died (p = .803).Conclusions: During an average of 101 months of follow-up mortality of accepted LD did not differ significantly as compared to the age standardized Serbian population and none of them developed ESRD. In examination of potential LD, the use of accurate and precise methods for kidney function estimation and the evaluation of risk for ESRD and mortality as well as treatment of modifiable contraindications for kidney donation are necessary.
Editor's comment:
Central nervous system (CNS) infection remains an important problem among transplant recipients. The recent review by Singh and Husain and this letter from Yugoslavia underline the following: a subacute‐chronic presentation is typical of fungal and bacterial CNS infections; early diagnosis is the key to effective therapy; the indication for a CNS evaluation is an unexplained headache, particularly in conjunction with a change in the level of consciousness (classical meningeal findings may not be present in a timely fashion); and the minimum CNS evaluation is a cranial computerized tomographic (CT) scan and a lumbar puncture.
Robert H. Rubin, MD
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