Outcome of the Assessment of Live Kidney Donation Candidates in the Antwerp University Hospital

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Abstract

We made an analysis of the outcome of the assessment of live kidney donation candidates in the Antwerp University Hospital to better understand and to improve this process. We analyzed 185 files of live kidney donation candidates over a period of 8 years (2008‐2015).

50 percent of all candidates actually doesn’t start the assessment. Of these candidates 40% becomes an effective live kidney donor, 47% is withdrawn of live kidney donation because of absolute contraindications and for 13% of them the assessment is prematurely stopped because the acceptor underwent a deceased kidney transplantation. In conclusion, 1 in 5 presenting live kidney donation candidates becomes an effective live kidney donor.

Regarding the absolute contraindications for live kidney donation we see that 82% of all live kidney donation candidates had contraindications incompatible with live kidney donation. More stunning is the fact that 42% of all candidates had contraindications incompatible with live kidney donation at the first contact, even before the actual assessment started. 80 percent of all contraindications is a medical contraindication, 20 percent is a non-medical contraindication. Of the medical contraindications the majority consists of smoking (18%), obesity (19%), cardiovascular disease/hypertension (19%) and other clearly defined medical diseases (26%) (not smoking, obesity, cardiovascular disease, bloodgroup incompatibility, diabetes and decreased kidney function). Of the non-medical contraindications motivation (50%) is the leading cause.

Of all live kidney donation candidates who actually start the assessment 50 percent has relative contraindications. 50% of all live kidney donation candidates with relative contraindications has more than 1 relative contraindication. The majority of relative contraindications consist of obesity (38%) and smoking (35%).40% of all effective live kidney donors had relative contraindications in the beginning and 67% of them had more than 1 contraindication. They managed to modify their relative contraindications, started the assessment and no other (absolute) contraindications were found.

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