The long-term acceptance of living donor transplantation has been based on a combination of excellent recipient outcomes and belief that in actuarial terms, there is no increased risk of living with one kidney. However, recent studies have raised controversy and concerns regarding the long-term risks of CKD in kidney donors. How do we interpret these findings? How do we evaluate and when do we clear donors with pre-existing medical conditions like hypertension, obesity, kidney stones, etc., and convey divergent opinions to patients? Comprehensive donor consent remains at the core of this process. Though perceived as challenging existing assumptions, the disclosure of new data will enable a better understanding of the risks so that potential living donors can make a more meaningful, informed decision.
Distinguish between “low risk donors” and medically complex living donors.
Evaluate the meanings of new studies regarding donor risk.
Refine the current informed consent process in light of the evolving data.