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Benefit of child-to-parent kidney donation
Eric P Cohen1, John D Rosendale, Christine J H Bong
1Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. ecohen@mcw.edu
Insights
Child-to-parent (CTP) kidney donation offers superior transplant and patient survival rates compared to cadaveric donation. This living donation method provides significant benefits that outweigh the minimal risks to the donor.
Area of Science:
- Nephrology
- Transplantation Surgery
- Medical Ethics
Background:
- Child-to-parent (CTP) kidney donation faces ethical scrutiny and effectiveness concerns.
- Living-related donation is a critical component of kidney transplantation.
Purpose of the Study:
- To evaluate the effectiveness of CTP kidney donation.
- To compare CTP donation outcomes against living-related (LD) and cadaveric kidney donation.
Main Methods:
- Analysis of the United Network for Organ Sharing (UNOS) database.
- Inclusion of 56,873 kidney transplants performed between 1988 and 1998.
Main Results:
- CTP kidney transplants demonstrated significantly greater transplant survival than cadaveric transplants.
- CTP kidney transplants showed significantly greater patient survival than cadaveric transplants.
- CTP donation offers an average gain of 3.6 years in kidney transplant half-life compared to cadaveric donation.
Conclusions:
- CTP kidney donation should be encouraged as a viable source for transplantable kidneys.
- The recipient benefits of CTP donation substantially exceed the donor risks.
- CTP donation is an effective and valuable method in kidney transplantation.
Abstract:
Use of child-to-parent (CTP) kidney donation may be limited because of ethical concerns as well as doubts about its effectiveness. We used the United Network for Organ Sharing database to examine the effectiveness of CTP kidney donation compared with other types of living-related (LD) kidney donation and to cadaveric kidney donation. Data from 56 873 kidney transplants performed between 1988 and 1998 showed significantly greater transplant and patient survival for CTP kidney transplants compared with cadaveric kidney transplants. The average gain in kidney transplant half-life is 3.6 years for a CTP compared with a cadaveric kidney transplant, and it is estimated that this gain for the recipient far outweighs the 1 in 3000 risk of death to the donor associated with kidney donation. We conclude that CTP kidney donation should not be discouraged, and represents a useful source of transplantable kidneys.