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CC BY-NC-ND 4.0 · Avicenna J Med 2021; 11(04): 172-184
DOI: 10.1055/s-0041-1736541
Original Article

Practice Patterns in the Acceptance of Medically Complex Living Kidney Donors with Obesity, Hypertension, Family History of Kidney Disease, or Donor-Recipient Age Discrepancy

Ziad Arabi
1   Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
,
Muhammad Bukhari 
2   Department of Medicine, Division of Adult Nephrology, Taif University, Taif, Saudi Arabia
,
Abdullah Hamad 
3   Department of Medicine, Division of Nephrology, Regional Medical Center of Orangeburg and Calhoun Counties, Orangeburg, South Carolina, United States
,
Abdulrahman Altheaby 
1   Department of the Organ Transplant Center, Division of Adult Transplant Nephrology, King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
,
Saleh Kaysi
4   Department of Medicine, Division of Nephrology, CHU, Clermont-Ferrand, France
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Abstract

Background To assess the practice patterns of the acceptance of medically complex living kidney donors (MCLKDs).

Methods We distributed a survey to nephrologists and transplant surgeons (TS) across the world through major international transplant societies. The survey contained questions regarding obesity, abnormal blood glucose profile, mild hypertension, donor-recipient age discrepancy, or family history of kidney disease of unknown etiology.

Results In total, 239 respondents from 29 countries (42% were nephrologists and 58% were TS).

Most respondents would allow donations from obese donors, especially if they intended to lose weight but would be cautious if these donors had abnormal blood glucose or family history of diabetes mellitus. In hypertensive donors, future pregnancy plans mattered in decisions regarding the acceptance of female donors. Most respondents would allow young donors but would be more cautious if they had a future risk of hypertension or a family history of kidney disease of unknown etiology. They would also allow donations from an older person if prolonged waiting time was anticipated. We found multiple areas of consensus of practice among the diverse members of international transplant societies, with some interesting variations among nephrologists and TS.

Conclusions This survey highlights the practice patterns of the acceptance of MCLKDs among the international community. In the absence of clear guidelines, this survey provides additional information to counsel kidney donors with these conditions.

Keywords

Age - Diabetes - Extended criteria - Family history of kidney disease - Gender - Hypertension - Living kidney donor - Metabolic syndrome - Obesity - Pregnancy - Survey

Disclosure

The authors declare no conflicts of interest.


Financial Support

None.




Publication History

Article published online:
15 November 2021

© 2021. Syrian American Medical Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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