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Recommendations for living donor kidney transplantation

2022; Elsevier BV; Volume: 42; Linguagem: Inglês

10.1016/j.nefroe.2022.07.001

2013-2514

M.Á. Frutos, Marta Crespo, María de la Oliva Valentín, Ángel Alonso-Melgar, Juana Alonso, Constantino Fernández, Gorka García-Erauzkin, Esther González, Ana González‐Rinne, Lluís Guirado, Álex Gutiérrez-Dalmau, J. Huguet, José Luis Moral, Mireía Musquera, David Paredes, Dolores Redondo‐Pachón, Ignacio Revuelta, Carlos J. van-der Hofstadt Román, Antonio Alcaraz, Ángel Alonso-Hernández, Manuel Alonso, Purificación Bernabeu, Gabriel Bernal, Alberto Breda, Mercedes Cabello, José Luis Caro-Oleas, Joan Cid, Fritz Diekmann, Laura Espinosa, Carme Facundo, Marta García, Salvador Gil‐Vernet, Miquel Lozano, Beatriz Mahíllo, María José Busto Martínez, B Miranda, Federico Oppenheimer, Eduard Palou, María José Pérez‐Sáez, Lluís Peri, Óscar Rodríguez, Carlos Santiago, Guadalupe Tabernero, Domingo Hernández, Beatriz Domínguez‐Gil, Julio Pascual,

Renal and Vascular Pathologies

This Guide for Living Donor Kidney Transplantation (LDKT) has been prepared with the sponsorship of the Spanish Society of Nephrology (SEN), the Spanish Transplant Society (SET), and the Spanish National Transplant Organization (ONT). It updates evidence to offer the best chronic renal failure treatment when a potential living donor is available. The core aim of this Guide is to supply clinicians who evaluate living donors and transplant recipients with the best decision-making tools, to optimise their outcomes. Moreover, the role of living donors in the current KT context should recover the level of importance it had until recently. To this end the new forms of incompatible HLA and/or ABO donation, as well as the paired donation which is possible in several hospitals with experience in LDKT, offer additional ways to treat renal patients with an incompatible donor. Good results in terms of patient and graft survival have expanded the range of circumstances under which living renal donors are accepted. Older donors are now accepted, as are others with factors that affect the decision, such as a borderline clinical history or alterations, which when evaluated may lead to an additional number of transplantations. This Guide does not forget that LDKT may lead to risk for the donor. Pre-donation evaluation has to centre on the problems which may arise over the short or long-term, and these have to be described to the potential donor so that they are able take them into account. Experience over recent years has led to progress in risk analysis, to protect donors' health. This aspect always has to be taken into account by LDKT programmes when evaluating potential donors. Finally, this Guide has been designed to aid decision-making, with recommendations and suggestions when uncertainties arise in pre-donation studies. Its overarching aim is to ensure that informed consent is based on high quality studies and information supplied to donors and recipients, offering the strongest possible guarantees.