Christian Kuhn , Aurelia Schnyder , Wolfgang Ender , Anna Wiegand , Patrick Folie , Isabelle Binet , Alexander Ritter
{"title":"Why Living Kidney Donors Are Declined: A Swiss Single Center Observation Over 15 Years","authors":"Christian Kuhn , Aurelia Schnyder , Wolfgang Ender , Anna Wiegand , Patrick Folie , Isabelle Binet , Alexander Ritter","doi":"10.1016/j.transproceed.2025.06.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Living kidney donation plays a crucial role in addressing organ shortage. Careful and holistic donor assessment is required to minimize donor risks. While acceptance patterns are well documented, donor candidates beyond the threshold remain largely unexamined. This study aims to analyze donor evaluations to identify reasons and trends for donor decline.</div></div><div><h3>Methods</h3><div>In this retrospective observational study, we analyzed prospectively collected data of 275 potential living kidney donor evaluated at our center between 2007 and 2021, assessing demographic and health characteristics, as well as the reasons for donor decline.</div></div><div><h3>Results</h3><div>Of the 275 donor candidates evaluated, 197 (71.6%) were declined. The primary reasons were medical and surgical issues (32.7%), particularly kidney-related conditions (9.5%), followed by immunological factors (21.1%) and psychosocial concerns (12.7%). Interestingly, there was a trend towards accepting medically more complex donors over the study period, with an increase in mean donor age and lower estimated glomerular filtration rate of accepted donors.</div></div><div><h3>Conclusion</h3><div>Donor decline is influenced by a range of medical, immunological, and psychosocial factors. These findings highlight the importance of individualized assessments and call for further research into overcoming donation barriers and evaluating long-term outcomes, particularly for medically complex donors, to optimize safe and effective living kidney donation.</div></div>","PeriodicalId":23246,"journal":{"name":"Transplantation proceedings","volume":"57 6","pages":"Pages 1041-1049"},"PeriodicalIF":0.8000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transplantation proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0041134525003148","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Living kidney donation plays a crucial role in addressing organ shortage. Careful and holistic donor assessment is required to minimize donor risks. While acceptance patterns are well documented, donor candidates beyond the threshold remain largely unexamined. This study aims to analyze donor evaluations to identify reasons and trends for donor decline.
Methods
In this retrospective observational study, we analyzed prospectively collected data of 275 potential living kidney donor evaluated at our center between 2007 and 2021, assessing demographic and health characteristics, as well as the reasons for donor decline.
Results
Of the 275 donor candidates evaluated, 197 (71.6%) were declined. The primary reasons were medical and surgical issues (32.7%), particularly kidney-related conditions (9.5%), followed by immunological factors (21.1%) and psychosocial concerns (12.7%). Interestingly, there was a trend towards accepting medically more complex donors over the study period, with an increase in mean donor age and lower estimated glomerular filtration rate of accepted donors.
Conclusion
Donor decline is influenced by a range of medical, immunological, and psychosocial factors. These findings highlight the importance of individualized assessments and call for further research into overcoming donation barriers and evaluating long-term outcomes, particularly for medically complex donors, to optimize safe and effective living kidney donation.
期刊介绍:
Transplantation Proceedings publishes several different categories of manuscripts, all of which undergo extensive peer review by recognized authorities in the field prior to their acceptance for publication.
The first type of manuscripts consists of sets of papers providing an in-depth expression of the current state of the art in various rapidly developing components of world transplantation biology and medicine. These manuscripts emanate from congresses of the affiliated transplantation societies, from Symposia sponsored by the Societies, as well as special Conferences and Workshops covering related topics.
Transplantation Proceedings also publishes several special sections including publication of Clinical Transplantation Proceedings, being rapid original contributions of preclinical and clinical experiences. These manuscripts undergo review by members of the Editorial Board.
Original basic or clinical science articles, clinical trials and case studies can be submitted to the journal?s open access companion title Transplantation Reports.