Incidental Discovery of Health Issues May Benefit Living Kidney Donors
Counseling of potential living kidney donors should include discussion of the possibility of finding serious undiagnosed medical problems.
Possible discovery of undiagnosed serious medical problems should be discussed with living kidney donor candidates as part of the consent process, according to researchers.
Arika L. Hoffman, MD, and colleagues at the University of Nebraska Medical Center in Omaha reviewed data from all potential living kidney donors evaluated over a 10-year period at their institution. Of 762 potential donors, 65 (8.5%) were disqualified from donating a kidney because of a newly diagnosed serious medical condition discovered during their evaluation, Dr Hoffman's team reported online ahead of print in Clinical Transplantation.
The disqualified candidates included 6 individuals with malignancies (5 requiring operative intervention), 6 with transmittable diseases requiring follow-up and treatment, 4 with bilateral renal stones with significant stone burden, and 2 diagnosed with IgA nephropathy. Another 4 patients were diagnosed with significant heart disease, and 1 of these patients subsequently required coronary artery bypass surgery.
“We propose that all transplant centers discuss the potential for direct medical benefit to the donor candidate as a result of the living donor evaluation,” Dr Hoffman and her colleagues reported.
The investigators noted that almost all transplant centers that perform living donor transplantation have a written consent form describing the required medical and psychological risks associated with donation, and only 30% of consent forms list discovery of previously undiagnosed health problems as a benefit to the donor.
Hoffman A, Tendulkar K, Merani S, et al. Fortuitious benefits of living kidney donation: Diagnosis of serious medical conditions during the living donor evaluation. Clin Transplant. 2018 Jan 18 doi: 10.1111/ctr.13204