Living Kidney donation is accepted by law, religion and bioethics, provided that the donor is aware of the consequences of his/her act & makes the decision without outside pressure or commercialism. Living donor evaluation includes a medical history, physical examination, laboratory tests, serologic screening & imaging studies in order to reach the following conclusions:-
1. Donor has
compatible blood and cross-match with the recipient.
2. Donor is
healthy, with no unacceptable medical or surgical risk after donor nephrectomy.
3. Donors will
have a stable renal function after donation.
4. Donor does
not have transmissible infection or malignancy.
5. Donor has acceptable renal anatomy.
6. Donor does
not have nor will have a psychosocial problems.
In order to fulfill
the above conclusion, the following is the algorithm we follow:-
ABSOLUTE
EXCLUSION CRITERIA Ø Age <18 years
Hypertension in
someone younger than 50 years old,
Evidence of end-organ damage, or on three or more anti-hypertensive medications
A.
Diabetes (diagnosis of diabetes)
or abnormal glucose tolerance test History of thrombosis or embolism
B.
Psychiatric contraindications
C.
Obesity: BMI>35kg/m2
D.
Coronary Artery Disease
E.
Symptomatic Valvular Disease
F.
Peripheral Vascular Disease
G.
Symptomatic Valvular Disease
H.
Chronic lung disease with
impairment of oxygenation or ventilation Recent malignancy, or cancer with long times
to recurrence eg.,
I.
breast cancer
J.
Significant Urologic
abnormalities of donor kidney Ø
K.
Proteinuria>300 mg/24hours
L.
HIV infection RELATIVE
CONTRAINDICATIONS:-
M.
Hepatitis C Virus Infection
N.
Hepatitis B Virus Infection
O.
Age 18-21 years old; elderly
donors especially those without significant comorbid disease
P.
Obesity (BMI 30-35)
Q.
Kidney stones
R.
Distant history of cancer
S.
Past history of psychiatric
disorder
T.
Renovascular Disease
U.
Thin basement membrane disease
V.
Prior valve surgery
W.
Moderate Cardiac Valvular Disease
with otherwise normal echocardiographic findings
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