Medical Evaluation Of The Living Kidney Donor

Living kidney donors have voluntarily assumed the immediate risks of elective surgery, as well as the less well-defined medium and longer term risks to their future health, in gifting half their kidney function to another person. Yet despite this considerable responsibility placed on the living kidney donor, physician advocate, and transplant team members, protocols for the evaluation of potential donors may differ substantially between centers. While a number of published expert recommendations serve as a basis for most living donor protocols, including one for living donors in the United States, the United Kingdom guidelines, and the Amsterdam Living Kidney donor guidelines, variability in guidance regarding donors of older age, with hypertension, and evaluation of diabetes risk, baseline kidney function, and anatomical imaging requirements, persist due in part to the relative lack of detailed longitudinal outcomes data. This chapter seeks to provide a comprehensive approach to the counseling and medical evaluation of potential living donor based on a critical review of the available scientific literature on potentially adverse risk factors.