Related Experiment Video
Updated: Jan 13, 2026
Using a Chemical Biopsy for Graft Quality Assessment
Published on: June 17, 2020
The cardiovascular evaluation of candidates for living kidney donation
Keshvi Chauhan1, Neetika Garg2, Matthew R Wolff1
1Division of Cardiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States of America.
Insights
Living kidney donation may pose cardiovascular risks for medically complex individuals. This review examines risks, screening, and offers guidance for donor selection and follow-up in higher-risk populations.
Area of Science:
- Nephrology
- Cardiology
- Transplant Surgery
Background:
- Previous studies on living kidney donation and cardiovascular risk often excluded high-risk individuals.
- Transplant programs face increasing numbers of medically complex living kidney donors.
- Current donor selection practices vary significantly across institutions.
Purpose of the Study:
- To review existing evidence on post-donation cardiovascular outcomes in living kidney donors.
- To identify prevalent cardiovascular risk factors in potential living kidney donors.
- To provide recommendations for risk stratification and donor selection in higher-risk individuals.
Main Methods:
- Comprehensive literature review of studies on living kidney donor cardiovascular outcomes.
- Examination of prevalent risk factors: older age, hypertension, diabetes, obesity, dyslipidemias, metabolic syndrome.
- Review of atherosclerotic cardiovascular disease risk calculators for screening and optimization.
- Analysis of electrocardiographic and echocardiographic abnormalities in the general population to inform donor risk assessment.
Main Results:
- Limited data exists on cardiovascular outcomes for living kidney donors with pre-existing risk factors.
- Prevalence and natural history of common screening abnormalities in donors are not well-established.
- Extrapolation from general population data suggests a need for careful risk stratification.
Conclusions:
- Living kidney donation in higher-risk individuals requires careful consideration of long-term cardiovascular risks.
- Standardized screening, risk stratification, and medical optimization are crucial for donor selection.
- Informed consent and further research are essential for understanding long-term cardiovascular effects in complex donor populations.
Abstract:
Most studies concluding that living kidney donation does not increase cardiovascular risk have been conducted in low-risk cohorts. As transplant programs increasingly encounter medically complex donors, careful consideration of long-term cardiovascular risks is essential. There is significant variation among institutions in the practices regarding the selection of living donors. This comprehensive review examines the existing evidence on post-donation cardiovascular outcomes, and prevalent risk factors in the donor candidate population including older age, hypertension, prediabetes, diabetes, obesity, dyslipidemias and metabolic syndrome. The use of atherosclerotic cardiovascular risk calculators for coronary artery disease screening and medical optimization is discussed. Data on outcomes with commonly encountered electrocardiographic and echocardiographic abnormalities identified on screening tests in the donor population are essentially non-existent. To address this gap, we review the literature on their prevalence, natural history and outcomes in the general population. Extrapolating from these data, we make recommendations on risk stratification, decision-making regarding donor selection and follow up. Uncertainties in the context of living kidney donation are highlighted. This review underscores the importance of informed consent, and the need for ongoing research regarding long-term cardiovascular effects of kidney donation in higher-risk individuals.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:29Assessment of the Cardiovascular System II: Inspection
Head and Neck
01:23Assessment of the Cardiovascular System I: Subjective Data
Initial Enquiry
Ask the patient about their primary concern and thoroughly explore all reported symptoms.
Medical History
Investigate past illnesses affecting the cardiovascular system, such as angina, anemia, rheumatic fever, congenital heart disease, stroke, thrombophlebitis, dysrhythmias, varicosities
Inquire about symptoms...
01:28Cardiac Catheterization I: Pre-Procedure Overview