The Challenge of Detect and Characterize the Early Risk in Living Kidney Donor Transplant Col4a Nephropathy?

Evaulating patients for living kidney donor transplantation involving a recipient with significant medical issues can create an ethical debate about whether to proceed with surgery. Donors must be informed of the surgical risk to proceed with donating a kidney and their decision must be a voluntary one. A detailed informed consent should be obtained from high-risk living kidney donor transplant recipients as well as donors and family members after the high perioperative risk potential has been explained to them. In addition, family members need to be informed of and acknowledge that a living kidney donor transplant recipient with pretransplant extrarenal morbidity has a higher risk of a serious adverse outcome event such as graft failure or recipient death. We review 2 cases involving living kidney donor transplant recipients with significant comorbidity and discuss ethical considerations, donor risk, and the need for an extended informed consent.

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Telehealth Use by Living Kidney Donor Transplant Programs During the COVID-19 Pandemic and Beyond: a Practical Approach

Current Transplantation Reports ◽

10.1007/s40472-021-00339-w ◽

2021 ◽

Author(s):

Anju Yadav ◽

Pooja Singh

Keyword(s):

Practical Approach ◽

Kidney Donor ◽

Living Kidney Donor ◽

Donor Transplant

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Metabolic Syndrome, a Real Barrier for Living Kidney Donor Transplant

Transplantation Proceedings ◽

10.1016/j.transproceed.2020.02.018 ◽

2020 ◽

Vol 52 (4) ◽

pp. 1072-1076

Author(s):

L.R. López y López ◽

J. Martínez González ◽

J. Bahena Méndez ◽

D. Espinoza-Peralta ◽

N.P. Campos Nolasco ◽

...

Keyword(s):

Metabolic Syndrome ◽

Kidney Donor ◽

Living Kidney Donor ◽

Donor Transplant

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The Adoption of a One-Day Donor Assessment Model in a Living Kidney Donor Transplant Program: A Quality Improvement Project

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2017.07.013 ◽

2018 ◽

Vol 71 (2) ◽

pp. 209-215 ◽

Cited By ~ 14

Author(s):

Judi M. Graham ◽

Aisling E. Courtney

Keyword(s):

Quality Improvement ◽

Quality Improvement Project ◽

Assessment Model ◽

Kidney Donor ◽

Living Kidney Donor ◽

Improvement Project ◽

Transplant Program ◽

Donor Transplant

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Trapianto renale da donatore vivente

Giornale di Clinica Nefrologica e Dialisi ◽

10.33393/gcnd.2021.2250 ◽

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.

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