Evaluating Risk in Kidney Living Donors

Area of Science:

• Nephrology
• Transplant Surgery
• Public Health

Background:

• Living kidney donation is crucial due to organ shortages and improved transplant outcomes.
• Expanded donor criteria include older individuals and those with pre-existing conditions, increasing the need for safety monitoring.
• Ensuring donor safety, both short- and long-term, is paramount to prevent kidney replacement therapy, cardiovascular events, and premature death.

Purpose of the Study:

• To review the challenges in evaluating long-term consequences for living kidney donors.
• To address risks such as end-stage kidney disease, cardiovascular mortality, gestational complications, and hypertension.
• To align with calls for action promoting living kidney donation.

Main Methods:

• Mini-review of existing literature on long-term outcomes of kidney donation.
• Analysis of evidence regarding risks to living donors.
• Discussion of current monitoring recommendations and their limitations.

Main Results:

• Lifelong monitoring of living donors is essential for early detection of preventable illnesses.
• Annual follow-up should assess blood pressure, BMI, kidney function, albuminuria, lifestyle, and well-being.
• Management targets and genetic counseling recommendations for living donors are not well-defined.

Conclusions:

• Further research is needed to establish clear guidelines for managing risk factors in living kidney donors.
• Optimizing lifelong monitoring protocols is critical for the sustained health of living kidney donors.
• This review highlights areas for improvement in supporting living kidney donors throughout their lives.