Approach to the Pretransplant Evaluation of the Living Kidney Donor

Abstract

Evaluation of the potential kidney donor is a complex activity that differs substantially from other types of preoperative assessments. The well being of the donor, who derives no medical benefit from this surgery, must be assured in both the short term and long term, and the potential adverse consequences to the recipient must be determined as well. The criteria that must be met for a person to donate a kidney are rigorous and include medical, social, psychosocial, ethical, and legal issues. Donor evaluation can be divided into assessments to protect the health and safety of the donor and assessments to protect the health and safety of the recipient. This article provides an approach to evaluating a donor, focusing on the complex issues that an evaluator is faced with. A careful assessment of risks and benefits to both the donor and recipient can lead to favorable outcomes.

Exclusion Reasons of Living Kidney Donor Candidates: A Single-Center Experience

“…There are international consensus reports on the standard definition for the evaluation of LKD (5)(6)(7)(8). Medical causes such as obesity, hypertension and DM are the significant exclusion reasons for living kidney donation (9-13).…”

“…Evaluation and exclusion reasons of living donor candidates might differ among centers, although there are some international consensus reports on the standard definition for the evaluation of living donor candidates (5)(6)(7)(8). Obesity, hypertension, low estimated glomerular filtration rate (GFR) are the major contraindications for donor exclusion in the literature of several countries (9-13).…”

Post nephrectomy renal function: Donor nephrectomy vs. radical nephrectomy

“…the nephron. Serum creatinine-based estimation equations [eGFR Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Modification of Diet in Renal Disease (MDRD)] were used to estimate the GFR, which is also a recommendation based on the KDIGO guidelines [12][13][14] In this way, the patients" renal function was assessed using the data obtained from their pre-operative and post-operative laboratory parameters (urea, creatinine, urine).…”

“…Making a good choice whether one is an optimal kidney donor is a very important fact for the donor"s long-term health. According to the papers published so far, renal function following donor nephrectomy, expressed as glomerular filtration rate GFR, decreases annualy on average by -0.42 ml/min/1.73m 10,11,12,13. Following donor nephrectomy, there is an immediate decrease in renal mass by 50%, and also in the estimate glomerular filtration rate (eGFR), which later reaches approximately 70% of the predonation value 10,11,12 .…”