Expanding the Living Donor Pool, “Ist Act”: Analysis of the Causes of Exclusion of Potential Kidney Donors

Expanding the Living Donor Pool “Second Act”: Laparoscopic Donor Nephrectomy and ABO-Incompatible Kidney Transplantation Improve Donor Recruitment

“…We have shown previously that an accurate analysis of the causes of exclusion of donors can help to increase the number of potential living donors [3]. The present study confirms that combining this analysis with both the offer of a mini-invasive donor nephrectomy technique and the extension of acceptance criteria to ABOi donors can act as a booster in the recruitment of potential donors.…”

“…Almost 7000 patients are currently on the waiting list for deceased donor kidney transplantation in Italy [1]. Living donor kidney transplantation (LDKT) offers superior graft outcomes when compared with deceased-donor transplantation [2], however, only 11% of the kidneys transplanted in Italy in the 2012 came from a living donor [3]. LDKT began at our institution in the early 1970s, since then the number of procedures has never surpassed single digits, the average number being usually in the range of 2e3 per year.…”

“…Moreover, ABOincompatible (ABOi) LDKT has been accepted as a valid alternative therapy for end-stage renal disease and the outcome of ABOi LDKT has become equivalent to ABOcompatible (ABOc) LDKT in adult and pediatric recipients [7,8]. To safely expand our living donor pool and increase access to kidney transplantation, we recently decided to change strategy and work on 3 areas: analysis of the causes of exclusion of potential donors, the results of which have been recently published by our group [3], transition from open donor nephrectomy to LDN, introduction of ABOi living donor kidney transplantation. The present article focuses on the additional effects of LDN and ABOi on donor recruitment and living donor kidney transplantation at our center.…”

The experiences and impact of being deemed ineligible for living kidney donation: Semi‐structured interview study

“…Donors are usually motivated to donate to improve the wellbeing of their recipient and to fulfil a moral duty, with some motivated by improved self‐esteem from the opportunity to do good . However, about half of potential donors who commence workup do not donate because of medical or psychological contraindications …”

“…6 However, about half of potential donors who commence workup do not donate because of medical or psychological contraindications. [7][8][9] Living donor kidney transplantation is justified by an advantageous risk to benefit ratio for the donor. This entails weighing the potential risks to the living donor, against the benefits to the recipient over and above dialysis or waiting for a deceased donor kidney.…”