Practice Patterns in the Acceptance of Medically Complex Living Kidney Donors with Obesity, Hypertension, Family History of Kidney Disease, or Donor-Recipient Age Discrepancy

Purpose:
To assess the presence of variability in the practice patterns in the
acceptance of Medically Complex Living Kidney Donors (MCLKDs).
Method:
We distributed a survey to nephrologists and transplant surgeons
(TS) across the world through major international transplant
societies. The survey contains questions regarding obesity,
abnormal blood glucose profile, mild hypertension, or donor-
recipient age.
Results:
In total, 239 respondents from 29 countries (42% were nephrologists,
and 58% were TS).
Conclusions:
Most respondents would allow donations from obese donors,
especially, if they intended to lose weight but would be cautious
if these donors had abnormal blood glucose or family history of
diabetes mellitus. In hypertensive donors, future pregnancy plans
mattered in decisions regarding the acceptance of female donors.
Most respondents would allow young donors but would be more
cautious if they had a future risk of hypertension or a family history
of kidney disease of unknown etiology. They would also allow
donations from an older person if prolonged waiting time was
anticipated. We found multiple areas of consensus of practice
among the diverse members of international transplant societies
with some interesting variations among nephrologists and TS. This
survey highlights areas of practice in which guidelines are needed
regarding the acceptance of MCLKDs.