Shifting Paradigms in Live Kidney Donation and Transplantation

Abstract

Although patients with end-stage renal disease (ESRD) can be successfully treated with haemodialysis or peritoneal dialysis, kidney transplantation is by far the best therapeutic option for the majority of patients with ESRD. Regretfully, the shortage in donor organs prevails. Despite an impressive societal and governmental investment, the number of deceased donor kidneys that becomes available for transplantation remains insufficient to meet the demand. One of the solutions to this problem is live kidney donation. The advantages of live donor kidney transplantation are numerous and include, among others, that it is an elective operation with short ischemia times. Furthermore, in this way, transplant professionals are able to select good quality kidneys of healthy donors. A uniform approach in the selection of live kidney donors is especially important since the community is seeking for options to further expand the donor pool. Currently, there is a tendency towards accepting so called ‘extended criteria live kidney donors’, which this thesis is about.