Age

Aging of the general population and the attendant increase in End stage renal disease has widened the gap between available cadaver kidneys and demand. It appears that there is the development of an organ "social security" system in which younger donors

TABLE 4 ■ Contraindications for Live Kidney Donation

Absolute

Comments

Relative

Comments

Positive crossmatch

Desensitization

Blood type

Desensitization protocol

protocol

incompatibility

Monetary incentive

Positive flow cytometric

Desensitization protocol

Chronic kidney disease

crossmatch

Anatomic kidney

Heart disease

Age above 50 yrs;

abnormalities

require stress test

Diabetes

Hypertension

Blood pressure above

Pregnancy

Donate after

140/85 mmHg; may

delivery

require 24 hr home

Active infection

monitoring

Abnormal glucose

tolerance

Obesity

Above 35 kg/m2 (body

mass index); may

require weight loss

Malignancy

No evidence of disease

Hepatitis

Tuberculosis

Psychiatric disease

Chronic nephrotoxic

drugs

Kidney stone history

Metabolic workup, 24 hr

urine studies, and CT scan

Abbreviation: CT, computed tomography.

There is no difference in recipient graft function when received from obese donors. However, the future health and well-being of obese donors is a real concern due to the significant risk factor for future diabetes and hypertension. The long-term health and renal function of obese donors with a solitary kidney is unknown.

Young adults with stones or a history of stones are probably not good candidates for donation. In older adults, a history of stones may not necessarily disqualify them as donors.

supply kidneys for older end-stage renal failure patients. Laparoscopic renal donation by elderly donors has been shown to be safe and efficacious (102), and an elderly source may alleviate some of the pressure on the younger generation.

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