| Abstract: |
The appropriate identification and preparation of kidney donors (both living and deceased) contribute critically to the success of the transplant endeavor on both the individual and the national levels. This chapter on the medical and surgical aspects of kidney donation is from a handbook that offers a practical guide for health care providers who manage kidney transplant patients. The authors divide the chapter into two sections: Part I addresses the selection and evaluation of living donors and the surgical techniques of living donor nephrectomy; Part II discusses these same issues for deceased kidney donors. Specific topics include the role of informed consent, the evaluation process, the psychosocial evaluation, risks of donation, donor age, assessment of surgical risks, the risk of disease transmission to the recipient, evaluation of future risk to the donor, assessment of renal function (glomerular filtration rate, proteinuria, hematuria, hypertension, diabetes, obesity, nephrolithiasis, inherited renal disease, autosomal dominant polycystic kidney disease, Alport syndrome, familial primary glomerulonephritis, and systemic lupus erythematosus), surgical evaluation of the living kidney donor, surgical techniques for living donor nephrectomy, long-term postnephrectomy issues (renal function, pregnancy, employment and insurance, and long-term medical care), and controversies and innovations in living kidney donor practice, including biologically unrelated donors, incompatible donor and recipient, paid donation, and the living donor registry. The second section discusses contraindications to deceased donor donation, the role of donor age, expanded criteria donors, donor biopsy, nephron dose, donation after cardiac death, diagnosis of brain death, techniques of deceased donor organ retrieval, and deceased donor kidney preservation. 2 figures. 10 tables. 32 references. |