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ORIGINAL ARTICLE
Year : 2016  |  Volume : 16  |  Issue : 4  |  Page : 109-118

An evidence-based protocol for a comprehensive assessment of living kidney donors: individualizing the long-term risk of living kidney donation


1 Renal Unit, Ipswich Hospital NHS Trust, Ipswich; Institute of Learning and Teaching, Faculty of Health and Science, University of Liverpool, Liverpool, UK
2 Institute of Learning and Teaching, Faculty of Health and Science, University of Liverpool, Liverpool, UK
3 Institute of Learning and Teaching, Faculty of Health and Science, University of Liverpool; Royal Liverpool University Hospital, Liverpool, UK
4 Institute of Learning and Teaching, Faculty of Health and Science, University of Liverpool, Liverpool; Sheffield Teaching Hospitals, Sheffield, UK

Correspondence Address:
Ahmed Halawa
Sheffield Teaching Hospitals, University of Sheffield, Sheffield, ZIB CODE S5 7AU
UK
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-9165.200353

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Kidney transplantation is the treatment of choice for patients with end-stage renal failure. Living kidney donation has increased over the past few years and now accounts for 34% of the total kidney transplant programme in the UK. Reasons for the increase in living kidney donation include shortage of deceased donor organs and the possibility to perform pre-emptive kidney transplantation and antibody-incompatible transplantation. In addition, some prefer living kidney donation as this option is associated with better patient and graft survival. However, although kidney donation is considered safe in low-risk individuals, it is important to remember that the donor will have to undergo major surgery and lead a life with a solitary kidney with associated lifelong implications including reduction in renal function. Despite various national guidelines, several studies have shown significant variation in acceptance criteria among centres. This mirrors the controversies as to whether donors with certain characteristics can be accepted for donation. This is particularly important given recent publications regarding the long-term risks associated with donor nephrectomy. In view of this, it is essential that prospective living kidney donors are fully informed of the risks associated with donor nephrectomy. This ensures that the process of living kidney donation is underpinned by informed consent that is freely given to ensure donor autonomy is safeguarded. In this review, we discuss the short-term and long-term risks associated with donor nephrectomy with a view to proposing a protocol to help individualize the assessment of the potential living kidney donor.


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