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Living Donor Evaluation and Selection

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  • First Online:
Contemporary Kidney Transplantation

Part of the book series: Organ and Tissue Transplantation ((OTT))

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Abstract

Living donors are frequently used for kidney transplantation in the United States. This option offers a superior patient and graft survival over deceased donor transplantation. It is also an excellent solution to close the widening gap between patients awaiting renal transplantation and number of transplants done. Organ Procurement and Transplantation Network (OPTN) has specified the minimum general and kidney-specific requirements for suitability as a living kidney donor. Transplant programs across the United States have specific medical criteria for living donation which may be beyond the minimum specified by OPTN. Although living kidney donation is deemed safe, a thorough evaluation to assess medical suitability, infectious and malignancy transmission risk, and assessment of residual organ reserve in the donor is required. This chapter covers all aspects of medical evaluation of the living kidney donor in detail. In general, most programs are now more willing to accept donors with treated hypertension, obesity, or a history of kidney stones provided that certain conditions are met. Such aspects of medically complex living kidney donors are also presented here. Certain recipient conditions that should prompt genetic testing in related living donor candidates are also discussed. Other OPTN requirements such as psychosocial evaluation of living donors and their follow-up by the donor center are also highlighted.

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Abbreviations

AER:

Albumin excretion rate

AUA:

American Urologic Association

BMI:

Body mass index

CMS:

Centers for Medicare and Medicaid Services

DTAC:

Disease Transmission and Advisory Committee

ESRD:

End-stage renal disease

KDIGO:

Kidney Disease Improving Global Outcomes

NAT:

Nucleic acid test

OPTN:

Organ procurement and transplantation network

PHS:

Public Health Service

SRTR:

Scientific Registry of Transplant Recipients

TBMN:

Thin basement membrane nephropathy

UNOS:

United Network for Organ Sharing

WHO:

World Health Organization

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Author information

Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Thomas Jefferson University, Philadelphia, PA, USA

    Pooja Singh & George Francos

  2. Division of Nephrology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Jerry McCauley

Authors
  1. Pooja Singh
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  2. George Francos
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  3. Jerry McCauley
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Corresponding author

Correspondence to Pooja Singh .

Editor information

Editors and Affiliations

  1. Transplant Surgery, Sidney Kimmel Medical College, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA

    Carlo Gerardo B. Ramirez

  2. Division of Nephrology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

    Jerry McCauley

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Singh, P., Francos, G., McCauley, J. (2018). Living Donor Evaluation and Selection. In: Ramirez, C., McCauley, J. (eds) Contemporary Kidney Transplantation. Organ and Tissue Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-19617-6_3

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  • DOI: https://doi.org/10.1007/978-3-319-19617-6_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19616-9

  • Online ISBN: 978-3-319-19617-6

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