Introduction:

The living donor guidelines were updated in March 2018. The acceptable GFR for donation become more conservative for some patients.

The purpose of this study was to evaluate the impact of these changes on our centre and to establish the number of potential kidney donors that would be at more risk after donating.

Method:

A prospective database was used to identify patients who donated between May 2011 and February 2018. Their pre-donation corrected GFR (by 51Cr-EDTA or iohexol) was noted and compared to the new 2018 guidelines. Follow-up data was collected.

Results:

There were 284 donations (M:F 129:155) in this period. Nineteen donors were identified with a GFR below the advisory range (M:F 11:8, mean age 48.9 years). Of these, 6  donors had a GFR of more than 4 points below advisory range. 3 were aged less than 30 years. 


Conclusion:

6.7% (n=19) of donors would have been below the advisory level for donation under new guidelines.

Nationally, there were 7307 living donor transplants in the same period. Assuming similar demographics allowing us to extrapolate this data, this would equate to 490 donors whose GFR is below the new guideline. The detailed assessment of renal function “is used to inform potential donors of the long-term risks of donation”. Now the guidelines are more conservative, is it our ethical duty to contact donors and explain their lifetime risk of renal dysfunction may be higher than anticipated?

BTSNHSBT-19