Assessment of potential living kidney donors: Options for increasing donation

Abstract

OBJECTIVE: The aim of this study was to report the outcome of assessments of potential donors within a single center and to identify what factors can be modifi ed to increase donation. METHODS: Between January 2003 and February 2008, 364 potential donors (237 related, 120 unrelated, and 7 altruistic) were referred to the stages assessment process for living kidney donation. Records of assessment and outcomes were entered prospectively into a spreadsheet maintained by the Living Donor Transplant Coordinator. RESULTS: Of the 143 potential donors proceeding to stage 2 assessments, 25 were excluded for medical and other reasons, and 46 are currently being assessed. Sixty-five donor nephrectomies were performed, with 7 awaiting surgery, giving a donation rate of 21.3% (65 of 305) and a potential donation rate of 24% (72 of 305) if all 7 successfully donate. The reasons for exclusion from stage 1 assessment included immunological considerations, multiple donors, and cadaveric transplantation of an intended recipient. DISCUSSION: Introduction of paired exchange and non-directed donation, ABO incompatible transplantation, or desensitization of potential recipients will improve living donation rates. Potential donors withdrawing either because of another more suitable donor or their recipient being transplanted could be made aware (no obligations) of the option of altruistic non-directed donation.