2013 - ISODP 2013 Congress

Oral Presentation 8 on Living Donation

15.6 - Assessment of Potential Renal Donors Using Principles of the Amsterdam Forum: A Single Centre Review

Presenter: Jeremy R., Chapman, Westmead, Australia
Authors: Jeremy Chapman, Andrew Emerson, Philip O'Connell, Henry Pleass, Lincoln Dealtry

Assessment of Potential Renal Donors Using Principles of the Amsterdam Forum: A Single Centre Review

Jeremy Chapman1, Andrew Emerson1, Philip O'Connell1, Henry Pleass1, Lincoln Dealtry1

1westmead hospital, westmead, Australia

We reviewed the reasons for living renal donor exclusion at our centre following implementation of recommendations for assessment made at the Amsterdam forum. A retrospective audit was therefore undertaken of all 577 potential renal donors considered by our centre between 6 April 2004 and 20 September 2012. Potential renal donors were 18-70 years of age, and were all assessed to have an altruistic motivation for donating, and being able to consent for the procedure.

Results: 53 donors were rejected for non-medical reasons and 186 for medical reasons. The three most common single criteria reasons for donor exclusion were HLA sensitisation/incompatibility (15%), impaired renal function (13%) and impaired glucose tolerance (10%). Hypertension was the most common reason for donor exclusion when paired with other assessment criteria. There was an equal gender balance with 52% of actual donors being female. Assessed first degree relatives were less likely to proceed to donation than more distant relatives and spouses.

Conclusions. Introduction of the paired kidney exchange program and approaches to transplantation of ABO incompatible kidneys may reduce donor exclusion by 15%, but data on long term follow up of donors with marginal medical criteria for acceptance will be required before liberalising acceptance criteria could be considered. 

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