scholarly journals Evaluation of the Medically Complex Living Kidney Donor

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Yasar Caliskan ◽  
Alaattin Yildiz
Keyword(s):  
Living Donor ◽  
Viral Infections ◽  
Evaluation Process ◽  
Living Donors ◽  
Stone Disease ◽  
Organ Shortage ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Living Donor Transplantation ◽  
History Of

Due to organ shortage and difficulties for availability of cadaveric donors, living donor transplantation is an important choice for having allograft. Live donor surgery is elective and easier to organize prior to starting dialysis thereby permitting preemptive transplantation as compared to cadaveric transplantation. Because of superior results with living kidney transplantation, efforts including the usage of “Medically complex living donors” are made to increase the availability of organs for donation. The term “Complex living donor” is probably preferred for all suboptimal donors where decision-making is a problem due to lack of sound medical data or consensus guidelines. Donors with advanced age, obesity, asymptomatic microhematuria, proteinuria, hypertension, renal stone disease, history of malignancy and with chronic viral infections consist of this complex living donors. This medical complex living donors requires careful evaluation for future renal risk. In this review we would like to present the major issues in the evaluation process of medically complex living kidney donor.

Financial Considerations in Living Organ Donation

2003 ◽  
Vol 13 (2) ◽  
pp. 130-136 ◽  
Author(s):  
Cheryl Jacobs ◽  
Charlie Thomas
Keyword(s):  
Living Donor ◽  
Healthcare Professionals ◽  
Evaluation Process ◽  
Living Donors ◽  
Organ Donors ◽  
Clinical Social Workers ◽  
Financial Situation ◽  
Living Donor Transplantation ◽  
Financial Consequences ◽  
Out Of Pocket Expenses

The shortage of cadaveric organs and increased success of living donor transplantation support the use of living organ donors. Clinical social workers have the opportunity to explore a variety of donor-specific issues when performing psychosocial evaluations of living donors, including motivation, psychological stability, and personal and family consequences of donation, as well as the direct and indirect financial consequences faced by living donors. Although most donor-related medical costs are covered, other associated expenses are not reimbursable and may put donors at risk for financial hardship. Out-of-pocket expenses also serve as a disincentive to donate for some volunteers. During the evaluation process, healthcare professionals should openly discuss how surgery, recovery, and any potential complications might impact prospective donors' financial situation. Donors can then decide whether they are able to realistically handle the costs of donation. We present the financial dilemmas experienced by many living donors and highlight efforts that have been made to deal with them.

scholarly journals COVID-19 and Living Donor Kidney Transplantation in Naples during the Pandemic

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Gaia Peluso ◽  
Silvia Campanile ◽  
Alessandro Scotti ◽  
Vincenzo Tammaro ◽  
Akbar Jamshidi ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Living Donor ◽  
Viral Infections ◽  
Elective Surgery ◽  
Deceased Donor ◽  
Kidney Transplants ◽  
Donor Kidney ◽  
Transplant Center ◽  
Living Donor Transplantation ◽  
Donor Kidney Transplantation

Introduction. SARS-CoV-2 is a virus that causes a potentially deadly syndrome that affects especially the respiratory tract. Kidney-transplanted patients are immunosuppressed and more susceptible to viral infections. We have examined our transplantation activity to explore the future role of kidney transplantation from deceased and living donors in COVID-19 era. Patients and Methods. The activity of our transplant center of Naples (one of the two transplant centers in Campania, South Italy) continued during the COVID-19 pandemic. We have analysed the kidney transplants carried out between March 9 and June 9, 2020, comparing these data with the numbers of procedures performed in the two previous years. Moreover, we have considered the possibility of performing living donor transplants during a worldwide pandemic. Results. From March 9, 2020, when the Italian lockdown begun, till June 9, 2020, five kidney transplants have been performed at our transplant center in Naples, all from deceased donors. The donors and the recipients have been screened for COVID-19 infection, and the patients, all asymptomatic, followed strict preventive measures and were fully informed about the risks of surgery and immunosuppression during a pandemic. All the transplanted patients remained COVID negative during the follow-up. The number of transplants performed has been constant compared to the same months of 2018 and 2019. In agreement with the patients, we decided to postpone living donor transplants to a period of greater control of the SARS-CoV-2 spread in Italy. Conclusion. Deceased donor kidney transplantation should continue, especially in a region with moderate risk, like Campania, with a more careful selection of donors and recipients, preferring standard donors and recipients without severe comorbidities. Living donor transplantation program, instead, should be postponed to a period of greater control of the SARS-CoV-2 spread, as it is an elective surgery and its delay does not determine additional risks for patients.

Kidney to Share

2021 ◽  
Author(s):  
Martha Gershun ◽  
John D., MD Lantos
Keyword(s):  
Kidney Transplantation ◽  
Organ Donation ◽  
Living Donor ◽  
Living Donors ◽  
Body Parts ◽  
Economic Policies ◽  
Complex Process ◽  
Major Operation ◽  
History Of ◽  
Healthy Body

This book tells the story of the author's decision to donate a kidney to a stranger. The book takes readers through the complex process by which such donors are vetted to ensure that they are physically and psychologically fit to take the risk of a major operation. The story is also placed in the larger context of the history of kidney transplantation and the ethical controversies that surround living donors. The book helps readers understand the discoveries that made transplantation relatively safe and effective as well as the legal, ethical, and economic policies that make it feasible. The book explores the steps involved in recovering and allocating organs. It analyzes the differences that arise depending on whether the organ comes from a living donor or one who has died. It observes the expertise — and the shortcomings — of doctors, nurses, and other professionals and describes the burdens that we place on people who are willing to donate. It asks us to consider just how far society should go in using one person's healthy body parts in order to save another person. The book provides an account of organ donation that is both personal and analytical. A combination of perspectives leads to a profound and compelling exploration of a largely opaque practice. The book pulls back the curtain to offer readers a more transparent view of the fascinating world of organ donation.

The History of Solid Organ Transplantation

2021 ◽  
pp. 22-52
Author(s):  
Lainie Friedman ◽  
J. Richard Thistlethwaite, Jr
Keyword(s):  
Organ Transplantation ◽  
Living Donor ◽  
Solid Organ Transplantation ◽  
Deceased Donor ◽  
Living Donors ◽  
Early Years ◽  
Solid Organ ◽  
Organ Transplants ◽  
History Of ◽  
Kidney Liver

This chapter provides a brief history of solid organ transplantation. Although the focus is on the living donor, the history of living donor solid organ transplantation is intertwined with the history of deceased donor solid organ transplantation. This is particularly true in the early years of solid organ transplantation when the earliest success for some solid organ transplants began with living donors, e.g. kidney, and began with deceased donors for other solid organ transplants, e.g. liver. The history of each solid organ in which living donors have supplied grafts (kidney, liver, lung, pancreas, intestines, and uterus) is described even though some are rarely if ever performed today, e.g. lung, intestine, pancreas. We also discuss the living domino donor—a candidate-recipient (most commonly the recipient of a deceased donor liver or heart) whose own organ is not discarded but is transplanted into another person.

Ethical Analysis of Living Organ Donation

2005 ◽  
Vol 15 (3) ◽  
pp. 303-309 ◽  
Author(s):  
Benita J. Walton-Moss ◽  
Laura Taylor ◽  
Marie T. Nolan
Keyword(s):  
Living Donor ◽  
Empirical Work ◽  
Ethical Analysis ◽  
Ethical Framework ◽  
Johns Hopkins Hospital ◽  
Living Donation ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Autonomous Choice ◽  
Autonomous Decision

In 2003, the first 3-way living kidney donor-swap was performed at Johns Hopkins Hospital in Baltimore, Md. Three new donor protocols including paired donation now allow unrelated individuals to serve as donors. Some ethicists have suggested that emotionally unrelated individuals not be permitted to donate because they will not experience the same satisfaction that a family member who is a donor experiences. Others who frame living donation as an autonomous choice do not see emotionally unrelated or even nondirected donation as ethically problematic. This article uses an ethical framework of principlism to examine living donation. Principles salient to living donation include autonomy, beneficence, and nonmaleficence. The following criteria are used to evaluate autonomous decision making by living donors, including choices made (1) with understanding, (2) without influence that controls and determines their action, and (3) with intentionality. Empirical work in these areas is encouraged to inform the ethical analysis of the new living donor protocols.

scholarly journals Trapianto renale da donatore vivente

2021 ◽  
Vol 33 ◽  
pp. 34-38
Author(s):  
Aris Tsalouchos ◽  
Maurizio Salvadori
Keyword(s):  
Kidney Failure ◽  
Living Donor ◽  
Atypical Hemolytic Uremic Syndrome ◽  
Primary Hyperoxaluria ◽  
Kidney Donor ◽  
Living Kidney Donor ◽  
Uremic Syndrome ◽  
End Stage ◽  
Cadaveric Donors ◽  
Donor Transplant

Kidney transplant is the best therapy to manage end-stage kidney failure. The main barriers limiting this therapy are scarcity of cadaveric donors and the comorbidities of the patients with end-stage kidney failure, which prevent the transplant. Living kidney donor transplant makes it possible to obviate the problem of scarcity of cadaveric donor organs and also presents better results than those of cadaveric transplant. The principal indication of living kidney donor transplant is preemptive transplant. This allows the patient to avoid the complications of dialysis and it has also been demonstrated that it has better results than the transplant done after dialysis has been initiated. Priority indications of living donor transplant are also twins and HLA identical siblings. We also have very favorable conditions when the donor is young and male. On the contrary, the living donor transplant will have worse results if the donors are over 60-65 years and the recipients are young, and this can be a relative contraindication. There is an absolute contraindication for the living donation when the recipient has diseases with high risk of aggressive relapse in the grafts: focal and segmental hyalinosis that had early relapse in the first transplant; atypical hemolytic uremic syndrome due to deficit or malfunction of the complement regulatory proteins; early development of glomerulonephritis due to anti-glomerular basement membrane antibody in patients with Alport syndrome; primary hyperoxaluria. Extreme caution should also be taken in the evaluation of the kidney donors. The risks of developing renal failure or other complications are low if an adequate pre-donation evaluation has been made according to the international guidelines.

scholarly journals Use of Expanded Criteria in Living Kidney Donors – the Crucial Factor for Improvement of the Kidney Transplant Programme in Republic of Macedonia

PRILOZI ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 5-7 ◽  
Author(s):  
Zivko Popov ◽  
Perko Kolevski ◽  
Ninoslav Ivanovski
Keyword(s):  
Developing Countries ◽  
Living Donor ◽  
Deceased Donor ◽  
Good Clinical Practice ◽  
Living Donors ◽  
Organ Shortage ◽  
Living Kidney Donors ◽  
The Past ◽  
Expanded Criteria ◽  
Hla Compatibility

Abstract Renal transplantation is surely the best treatment for Chronic Kidney Disease (CKD) patients in both developed and developing countries. Due to the tragic events in former Yugoslavia at the beginning of the nineties, it was not possible to develop a really good clinical practice in the field of transplantation. Facing the lack of Deceased Donor Donation Transplantation and any organ-sharing among the Balkan countries, we introduced a large and very ambitious living donor transplant programme including what were called expanded criteria living donors. In the period of the past 20 years elderly (above 65 years), unrelated (emotionally related), marginal and ABO incompatible living donors were accepted. Due to the skilled surgical team, powerful immunosupression and HLA compatibility testing, the results were promising and the number of complications very low. The authors concluded that use of an expanded criteria living donor is fully acceptable, especially in developing countries, and could ameliorate the severe organ shortage in the region.

The Older Living Kidney Donor: Part of the Solution to the Organ Shortage

2006 ◽  
Vol 82 (12) ◽  
pp. 1662-1666 ◽  
Author(s):  
John S. Gill ◽  
Jagbir Gill ◽  
Caren Rose ◽  
Nadia Zalunardo ◽  
David Landsberg
Keyword(s):  
Organ Shortage ◽  
Kidney Donor ◽  
Living Kidney Donor
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