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Genetic testing in living kidney donor candidates
Yasar Caliskan1, Laura Binari, Heidi M Schaefer
1Division of Nephrology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Current Opinion in Organ Transplantation
|February 26, 2026
Summary
Genetic testing enhances living kidney donor (LKD) evaluation by identifying inherited diseases and enabling safer donor selection. This personalized approach requires genetic counseling for ethical implementation and improved long-term donor health.
Area of Science:
- Nephrology
- Genetics
- Transplantation
Background:
- Living kidney donor (LKD) evaluation traditionally relies on clinical assessment.
- Genetic evaluation is increasingly important for related LKD candidates and those with suspected inherited kidney diseases.
- Genetic testing offers a more comprehensive approach to donor assessment.
Purpose of the Study:
- To review the role of genetic evaluation in LKD candidates.
- To highlight how genetic testing informs donor selection and counseling.
- To discuss the integration of genetic testing into LKD transplantation.
Main Methods:
- Review of current literature on genetic testing in LKD evaluation.
- Analysis of genetic screening strategies for monogenic kidney diseases.
- Examination of sequential testing approaches in recipients and donors.
Main Results:
- Genetic screening identifies monogenic kidney diseases in LKD candidates.
- Targeted genetic testing excludes at-risk donors carrying pathogenic variants.
- Sequential testing facilitates safe donation by non-carrier relatives.
- Challenges include limited clinician experience and constrained access to genetic specialists.
Conclusions:
- Genetic testing allows for personalized and preventive LKD evaluation.
- Ethical integration necessitates genetic counseling and shared decision-making.
- Longitudinal follow-up and research are crucial for establishing best practices.
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