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Reasons and effects of the decline of willing related potential living kidney donors

World Journal of Transplantation 2023年第5期13卷 276-289页

作者： Rabea Ahmed Gadelkareem Amr Mostafa Abdelgawad Nasreldin Mohammed Ahmed Reda Nashwa Mostafa Azoz Mohammed Ali Zarzour Hisham Mokhtar Hammouda Mahmoud Khalil Department of Urology Assiut Urology and Nephrology HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt Department of Internal Medicine-Nephrology Unit Assiut University HospitalFaculty of MedicineAssiut UniversityAssiut 71515Egypt

BACKGROUND Although the availability of related living donors(LDs)provides a better chance for receiving kidney transplantation(KT),the evaluation protocols for LD selection remain a safeguard for the LD’s *** protocols are variable from one center to another,resulting in variable rates of decline of the potential LDs(PLDs).The decline of willing PLDs may occur at any stage of evaluation,starting from the initial contact and counseling to the day of *** To identify the causes of the decline of PLDs,the predictors of PLD candidacy,and the effect on achieving *** A retrospective study was performed on the willing PLDs who attended our outpatient clinic for kidney donation to their related potential recipients between October 2015 and December *** variables influencing their candidacy rate and the fate of their potential recipients were *** groups of PLDs were compared:Candidate PLDs after a completed evaluation vs non-candidate PLDs with a complete or incomplete evaluation.A multivariate logistic regression was performed to assess the factors contributing to the achievement of PLD *** Of 321 willing PLDs,257 PLDs(80.1%)accessed the evaluation to variable extents for 212 potential recipients,with a mean age(range)of 40.5±10.4(18-65)years,including 169 females(65.8%).The remaining 64 PLDs(19.9%)did not access the *** 58 PLDs(18.1%)succeeded in donating,but 199 PDLs(62.0%)were declined;exclusion occurred in 144 PLDs(56.0%)for immunological causes(37.5%),medical causes(54.9%),combined causes(9.7%),and financial causes(2.1%).Regression and release occurred in 55 PLDs(17.1%).The potential recipients with candidate PLDs were not significantly different from those with non-candidate PLDs,except in age(P=0.041),rates of completed evaluation,and exclusion of PLDs(P<0.001).There were no factors that independently influenced the rate of PLD *** patients who failed to have KT after the decline of their P

关键词： Donor decline Donor evaluation Donor exclusion kidney transplantation living kidney donors Related living donors

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Hypertension and obesity in living kidney donors

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World Journal of Transplantation 2021年第6期11卷 180-186页

作者： Mahmoud M Mohamed Ahmed Daoud Syed Quadri Michael J Casey Mariah Aurora Posadas Salas Vinaya Rao Tibor Fülöp Karim M Soliman Department of Medicine Division of NephrologyUniversity of TennesseeMemphisTN 38163United States Department of Medicine Division of NephrologyCairo UniversityCairo 11562Egypt Department of Medicine Division of NephrologyMedical University of South CarolinaCharlestonSC 29425United States Medicine Service Ralph H.Johnson VA Medical CenterCharlestonSC 29401United States

Over the past few decades,the shortage in the kidney donor pool as compared to the increasing number of candidates on the kidney transplant waitlist led to loosening of kidney donors’acceptance *** and obesity represent risk factors for chronic kidney disease,both in native kidneys and those in kidney transplant *** great progress has been made in kidney transplantation from living donors to benefit the recipient survival and quality of life,progress has been slow to fully risk-characterize the *** review critically reassesses the current state of understanding regarding the risk of endstage kidney disease in those donors with obesity,hypertension or *** risk assessment tools need to be developed urgently to fully understand the risk glomerular filtration rate compensation failure in the remaining kidney of the donors.

关键词： living donor kidney Obesity Hypertension living kidney donors

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