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Kidney Transplantation: A Guide to the Care of Kidney Transplant Recipients pp 73–93Cite as

Live Donors: How to Optimally Protect the Donor

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Abstract

The purpose of this chapter is to offer evidence-based guidelines for donor selection practices – specific reasons to accept and specific reasons to refuse. This chapter also offers guidelines to assess the potential donor’s understanding of the risks and benefits of donation.

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References

  1. Coresh J, Selvin E, Stevens LA, Manzi J, Kusek JW, Eggers P, Van Lente F, Levey AS. Prevalence of chronic kidney disease in the United States. J Am Med Assoc 2007; 298: 2038–2047.

    Article  CAS  Google Scholar 

  2. Collins AJ, Foley RN, Herzog C, Chavers B, Gilbertson D, Ishani A, Kasiske B, Liu J, Mau LW, McBean M, Murray A, St Peter W, Guo H, Li Q, Li S, Li S, Peng Y, Qiu Y, Roberts T, Skeans M, Snyder J, Solid C, Wang C, Weinhandl E, Zaun D, Arko C, Chen SC, Dalleska F, Daniels F, Dunning S, Ebben J, Frazier E, Hanzlik C, Johnson R, Sheets D, Wang X, Forrest B, Constantini E, Everson S, Eggers P, Agodoa L. United States Renal Data System 2008 annual data report abstract. Am J Kidney Dis 2009; 53:vi–vii, S8–S374.

    Google Scholar 

  3. Gilbertson DT, Liu J, Xue JL, Louis TA, Solid CA, Ebben JP, Collins AJ. Projecting the number of patients with end-stage renal disease in the United States to the year 2015. J Am Soc Nephrol 2005; 16:3736–3741.

    Article  PubMed  Google Scholar 

  4. Kiberd BA, Clase CM. Cumulative risk for developing end-stage renal disease in the US population. J Am Soc Nephrol 2002; 13:1635–1644.

    Article  PubMed  Google Scholar 

  5. Gibney EM, King AL, Maluf DG, Garg AX, Parikh CR. Living kidney donors requiring transplantation: focus on African Americans. Transplantation 2007; 84:647–649.

    Article  PubMed  Google Scholar 

  6. Steiner RW, Danovitch G. The medical evaluation and risk estimation of end-stage renal disease for living kidney donors. In: RW Steiner (ed.), Educating, Evaluating, and Selecting Living Kidney Donors. Kluwer Academic Publishers, Dordrecht, The Netherlands, 2004, pp. 51–79.

    Chapter  Google Scholar 

  7. Steiner, RW. ‘Normal for Now’ or ‘At Future Risk’: A double standard for selecting young and older living kidney donors. Am J Transplant 2010. (In Press)

    Google Scholar 

  8. Delmonico F. A report of the Amsterdam forum on the care of the live kidney donor: data and medical guidelines. Transplantation 2005; 79:S53–S66.

    Article  PubMed  Google Scholar 

  9. Kavoussi LR. Laparoscopic donor nephrectomy. Kidney Int 2000; 57:2175–2186.

    Article  CAS  PubMed  Google Scholar 

  10. Patel S, Cassuto J, Orloff M, Tsoulfas G, Zand M, Kashyap R, Jain A, Bozorgzadeh A, Abt P. Minimizing morbidity of organ donation: analysis of factors for perioperative complications after living-donor nephrectomy in the United States. Transplantation 2008; 85: 561–565.

    Article  PubMed  Google Scholar 

  11. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130: 461–470.

    CAS  PubMed  Google Scholar 

  12. Issa N, Meyer KH, Arrigain S, Choure G, Fatica RA, Nurko S, Stephany BR, Poggio ED. Evaluation of creatinine-based estimates of glomerular filtration rate in a large cohort of living kidney donors. Transplantation 2008; 86:223–230.

    Article  CAS  PubMed  Google Scholar 

  13. Lemann J, Bidani AK, Bain RP, Lewis EJ, Rohde RD. Use of the serum creatinine to estimate glomerular filtration rate in health and early diabetic nephropathy. Collaborative Study Group of Angiotensin Converting Enzyme Inhibition in Diabetic Nephropathy. Am J Kidney Dis 1990; 16:236–243.

    CAS  PubMed  Google Scholar 

  14. Ishani A, Grandits GA, Grimm RH, Svendsen KH, Collins AJ, Prineas RJ, Neaton JD. Association of single measurements of dipstick proteinuria, estimated glomerular filtration rate, and hematocrit with 25-year incidence of end-stage renal disease in the multiple risk factor intervention trial. J Am Soc Nephrol 2006; 17:1444–1452.

    Article  CAS  PubMed  Google Scholar 

  15. Rook M, Bosma RJ, van Son WJ, Hofker HS, van der Heide JJ, ter Wee PM, Ploeg RJ, Navis GJ. Nephrectomy elicits impact of age and BMI on renal hemodynamics: lower postdonation reserve capacity in older or overweight kidney donors. Am J Transplant 2008; 8:2077–2085.

    Article  CAS  PubMed  Google Scholar 

  16. Marson LP, Lumsdaine JA, Forsythe JLR, Hartmann A. Selection and evaluation of potential living kidney donors. In: RS Gaston, J Wadstom (eds.), Living Donor Kidney Transplantation. Taylor and Francis, Abingdon, Oxon, 2005, pp. 33–54.

    Google Scholar 

  17. Ritz E, Orth SR. Nephropathy in patients with type 2 diabetes mellitus. N Engl J Med 1999; 341:1127–1133.

    Article  CAS  PubMed  Google Scholar 

  18. Havas S. The ACCORD Trial and control of blood glucose level in type 2 diabetes mellitus: time to challenge conventional wisdom. Arch Intern Med 2009; 169:150–154.

    Article  PubMed  Google Scholar 

  19. Ritz E. Metabolic syndrome: an emerging threat to renal function. Clin J Am Soc Nephrol 2007; 2:869–871.

    Article  PubMed  Google Scholar 

  20. Narayan KM, Boyle JP, Thompson TJ, Sorensen SW, Williamson DF. Lifetime risk for diabetes mellitus in the United States. J Am Med Assoc 2003; 290:1884–1890.

    Article  CAS  Google Scholar 

  21. Mandelbrot DA, Pavlakis M, Danovitch GM, Johnson SR, Karp SJ, Khwaja K, Hanto DW, Rodrigue JR. The medical evaluation of living kidney donors: a survey of US transplant centers. Am J Transplant 2007; 7:2333–2343.

    Article  CAS  PubMed  Google Scholar 

  22. Kasiske BL, Bia MJ. The evaluation and selection of living kidney donors. Am J Kidney Dis 1995; 26:387–398.

    Article  CAS  PubMed  Google Scholar 

  23. Reese PP, Feldman HI, McBride MA, Anderson K, Asch DA, Bloom RD. Substantial variation in the acceptance of medically complex live kidney donors across US renal transplant centers. Am J Transplant 2008; 8:2062–2070.

    Article  CAS  PubMed  Google Scholar 

  24. Iseki K, Ikemiya Y, Iseki C, Takishita S. Proteinuria and the risk of developing end-stage renal disease. Kidney Int 2003; 63:1468–1474.

    Article  PubMed  Google Scholar 

  25. Jones CA, Francis ME, Eberhardt MS, Chavers B, Coresh J, Engelgau M, Kusek JW, Byrd-Holt D, Narayan KM, Herman WH, Jones CP, Salive M, Agodoa LY. Microalbuminuria in the US population: third National Health and Nutrition Examination Survey. Am J Kidney Dis 2002; 39:445–459.

    Article  PubMed  Google Scholar 

  26. Knight EL, Kramer HM, Curhan GC. High-normal blood pressure and microalbuminuria. Am J Kidney Dis 2003; 41:588–595.

    Article  PubMed  Google Scholar 

  27. Kannel WB, Stampfer MJ, Castelli WP, Verter J. The prognostic significance of proteinuria: the Framingham study. Am Heart J 1984; 108:1347–1352.

    Article  CAS  PubMed  Google Scholar 

  28. Steiner RW, Gert B. Ethical selection of living kidney donors. Am J Kidney Dis 2000; 36: 677–686.

    CAS  PubMed  Google Scholar 

  29. Friedman AL, Lopez-Soler RI, Cuffy MC, Cronin DC 2nd. Patient access to transplantation with an Internet-identified live kidney donor: a survey of U.S. centers. Transplantation 2008; 85:794–798.

    Article  PubMed  Google Scholar 

  30. Choy BY, Chan TM, Lai KN. Recurrent glomerulonephritis after kidney transplantation. Am J Transplant 2006; 6:2535–2542.

    Article  CAS  PubMed  Google Scholar 

  31. Steiner RW. Risk appreciation for living kidney donors: another new subspecialty? Am J Transplant 2004; 4:694–697.

    Article  PubMed  Google Scholar 

  32. Winchester P, Kapur S, Prince MR. Noninvasive imaging of living kidney donors. Transplantation 2008; 86:1168–1169.

    Article  PubMed  Google Scholar 

  33. Rule A, Bergstralh E, Melton LJ, Li X, Weeaver A, Lieske J 2008. Kidney stones are associated with and increased risk of developing chronic kidney disease. In American Society of Nephrology Annual Meeting 2008. [F-FC202], Mayo Clinic; Health Sciences Research.

    Google Scholar 

  34. Thiel GT, Nolte C, Tsinalis D. Living kidney donors with isolated medical abnormalities: the SOL-DHR experience. In: RS Gaston, J Wadstom (eds.), Living Donor Kidney Transplantation. Taylor and Francis, Abingdon, Oxon, 2005, pp. 55–73.

    Google Scholar 

  35. Yamagata K, Takahashi H, Tomida C, Yamagata Y, Koyama A. Prognosis of asymptomatic hematuria and/or proteinuria in men. High prevalence of IgA nephropathy among proteinuric patients found in mass screening. Nephron 2002; 91:34–42.

    Article  PubMed  Google Scholar 

  36. Topham PS, Harper SJ, Furness PN, Harris KP, Walls J, Feehally J. Glomerular disease as a cause of isolated microscopic haematuria. Q J Med 1994; 87:329–335.

    CAS  PubMed  Google Scholar 

  37. McGregor DO, Lynn KL, Bailey RR, Robson RA, Gardner J. Clinical audit of the use of renal biopsy in the management of isolated microscopic hematuria. Clin Nephrol 1998; 49:345–348.

    CAS  PubMed  Google Scholar 

  38. Ibels LS, Gyory AZ, Caterson RJ, Pollock CA, Mahony JF, Waugh DA, Roger SD, Coulshed S. Primary IgA nephropathy: natural history and factors of importance in the progression of renal impairment. Kidney Int Suppl 1997; 61:S67–S70.

    CAS  PubMed  Google Scholar 

  39. Mancilla E, Avila-Casado C, Uribe-Uribe N, Morales-Buenrostro LE, Rodriguez F, Vilatoba M, Gabilondo B, Aburto S, Rodriguez RM, Magana S, Magana F, Alberu J. Time-zero renal biopsy in living kidney transplantation: a valuable opportunity to correlate predonation clinical data with histological abnormalities. Transplantation 2008; 86: 1684–1688.

    Article  PubMed  Google Scholar 

  40. Kincaid-Smith P. Hypothesis: obesity and the insulin resistance syndrome play a major role in end-stage renal failure attributed to hypertension and labelled ‘hypertensive nephrosclerosis’. J Hypertens 2004; 22:1051–1055.

    Article  CAS  PubMed  Google Scholar 

  41. Roland AS, Hildreth EA, Sellers AM. Occult primary renal disease in the hypertensive patient. Arch Int Med 1964; 113:101–110.

    CAS  Google Scholar 

  42. Vasan RS, Larson MG, Leip EP, Evans JC, O’Donnell CJ, Kannel WB, Levy D. Impact of high-normal blood pressure on the risk of cardiovascular disease. N Engl J Med 2001; 345:1291–1297.

    Article  CAS  PubMed  Google Scholar 

  43. Kasiske BL, Ma JZ, Louis TA, Swan SK. Long-term effects of reduced renal mass in humans. Kidney Int 1995; 48:814–819.

    Article  CAS  PubMed  Google Scholar 

  44. Garg AX, Muirhead N, Knoll G, Yang RC, Prasad GV, Thiessen-Philbrook H, Rosas-Arellano MP, Housawi A, Boudville N. Proteinuria and reduced kidney function in living kidney donors: A systematic review, meta-analysis, and meta-regression. Kidney Int 2006; 70:1801–1810.

    Article  CAS  PubMed  Google Scholar 

  45. Prasad GV, Lipszyc D, Huang M, Nash MM, Rapi L. A prospective observational study of changes in renal function and cardiovascular risk following living kidney donation. Transplantation 2008; 86:1315–1318.

    Article  PubMed  Google Scholar 

  46. Garg AX, Prasad GV, Thiessen-Philbrook HR, Ping L, Melo M, Gibney EM, Knoll G, Karpinski M, Parikh CR, Gill J, Storsley L, Vlasschaert M, Mamdani M. Cardiovascular disease and hypertension risk in living kidney donors: an analysis of health administrative data in Ontario, Canada. Transplantation 2008; 86:399–406.

    Article  PubMed  Google Scholar 

  47. Fehrman-Ekholm I, Elinder CG, Stenbeck M, Tyden G, Groth CG. Kidney donors live longer. Transplantation 1997; 64:976–978.

    Article  CAS  PubMed  Google Scholar 

  48. Mullaney SR, Zeigler MG. The risk of end stage renal disease for hypertensive kidney donors. In: RW Steiner (ed.), Educating, Evaluating, and Selecting Living Kidney Donors. Kluwer Academic Publishers, Dordrecht, The Netherlands, 2004, pp. 81–97.

    Chapter  Google Scholar 

  49. Weir MR. The renoprotective effects of RAS inhibition: focus on prevention and treatment of chronic kidney disease. Postgrad Med 2009; 121:96–103.

    Article  PubMed  Google Scholar 

  50. Zeier M, Geberth S, Gonzalo A, Chauveau D, Grunfeld JP, Ritz E. The effect of uninephrectomy on progression of renal failure in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1992; 3:1119–1123.

    CAS  PubMed  Google Scholar 

  51. Sampson MJ, Drury PL. Development of nephropathy in diabetic patients with a single kidney. Diabet Med 1990; 7:258–260.

    Article  CAS  PubMed  Google Scholar 

  52. Chang S, Caramori ML, Moriya R, Mauer M. Having one kidney does not accelerate the rate of development of diabetic nephropathy lesions in type 1 diabetic patients. Diabetes 2008; 57:1707–1711.

    Article  CAS  PubMed  Google Scholar 

  53. Steiner RW, Frederici CA. The education and counseling process for potential donors and donor attitudes after living kidney donation. In: RW Steiner (ed.), Educating, Evaluating, and Selecting Living Kidney Donors. Kluwer Academic Publishers, Dordrecht, The Netherlands, 2004, pp. 51–79.

    Chapter  Google Scholar 

  54. Steiner RW, Gert B. A technique for presenting risk and outcome data to potential living renal transplant donors. Transplantation 2001; 71:1056–1057.

    Article  CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. University of California at San Diego Medical Center, San Diego, CA, USA

    Robert Steiner MD

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  1. Robert Steiner MD
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Correspondence to Robert Steiner MD .

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Editors and Affiliations

  1. Scripps Research Institute, N.Torrey Pines Rd. 10550, La Jolla, 92037, USA

    Dianne B. McKay

  2. Division of Transplantation, Sharp Memorial Hospital, Frost Street 7910, San Diego, 92123, USA

    Steven M. Steinberg

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Steiner, R. (2010). Live Donors: How to Optimally Protect the Donor. In: McKay, D., Steinberg, S. (eds) Kidney Transplantation: A Guide to the Care of Kidney Transplant Recipients. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1690-7_6

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  • DOI: https://doi.org/10.1007/978-1-4419-1690-7_6

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