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Panning for gold: screening for potential live kidney donors
Francis R Calder1, Rene W Chang
1Department of Renal Medicine and Transplantation, St George's Hospital, Blackshaw Road, London SW17 0QT, UK. francis.calder@stgeorges.nhs.uk
Summary
Many potential living kidney donors do not complete the assessment process. Addressing immunological issues and providing better support can improve the success rate of live donor kidney transplantation.
Area of Science:
- Nephrology
- Transplantation Surgery
- Public Health
Background:
- Living donation is crucial for addressing the kidney transplant shortage.
- The extensive evaluation process deters many potential live kidney donors.
- Identifying barriers to completion is vital for increasing organ availability.
Purpose of the Study:
- To review reasons for failure in live donor renal assessment.
- To identify factors hindering completion of the donor work-up.
- To propose strategies for improving live donor assessment completion rates.
Main Methods:
- Retrospective analysis of data from potential live donors.
- Data collected over a 5-year period (1997-2001).
- Inclusion of all individuals entering the live donor assessment program.
Main Results:
- 189 potential donors entered assessment; only 34 (18%) donated.
- Major reasons for non-donation: immunological incompatibility (30%), withdrawal (27%), medical unfitness (15%), insufficient renal function (10%).
- Donors included siblings, parents, and unrelated individuals.
Conclusions:
- Live donor kidney transplantation provides high-quality organs but requires significant effort.
- Improving immunological matching and psychological support can enhance donor yield.
- Support for donors unable to proceed is essential.