Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017.

Tytuł:: Metabolic, cardiovascular, and substance use evaluation of living kidney donor candidates: US practices in 2017.
Autorzy:: Garg N; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Lentine KL; Center for Abdominal Transplantation, Saint Louis University School of Medicine, St. Louis, Missouri, USA.
Inker LA; Division of Nephrology, Department of Medicine, Tufts Medical Center Boston, Boston, Massachusetts, USA.
Garg AX; Division of Nephrology, Department of Medicine, Western University, London, ON, Canada.
Rodrigue JR; Transplant Institute, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.; Departments of Surgery and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA.
Segev DL; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mandelbrot DA; Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Źródło:: American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons [Am J Transplant] 2020 Dec; Vol. 20 (12), pp. 3390-3400. Date of Electronic Publication: 2020 May 22.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Publication: 2023- : [New York] : Elsevier
Original Publication: Copenhagen : Munksgaard International Publishers, 2001-
MeSH Terms:: Kidney Transplantation*/adverse effects
Living Donors*
Substance-Related Disorders*
Body Mass Index ; Donor Selection ; Humans ; Kidney ; United States
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Contributed Indexing:: Keywords: Clinical research/practice; Donors and donation: donor evaluation; Donors and donation: living; Hypertension/antihypertensives; United Network for Organ Sharing (UNOS); kidney transplantation/nephrology
Entry Date(s):: Date Created: 20200429 Date Completed: 20210520 Latest Revision: 20230124
Update Code:: 20240105
DOI:: 10.1111/ajt.15964
PMID:: 32342601
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We surveyed US transplant centers to assess practices regarding the evaluation and selection of living kidney donors based on metabolic, cardiovascular, and substance use risk factors. Our companion article describes renal aspects of the evaluation. Response rate was 31%. Compared with 2005, programs have become more accepting of hypertensive candidates: 65% in 2017% vs 41% in 2005 consider candidates with hypertension well controlled with 1 medication. One notable exception is black hypertensive candidates, who are frequently excluded regardless of severity. The most common body mass index (BMI) cutoff remains 35 kg/m 2 , and fewer programs now consider candidates with BMI >40 kg/m 2 . A 2-hour oral glucose tolerance test of ≥140 mg/dL remains the most common criterion for exclusion of prediabetic candidates. One quarter to one third of programs exclude based on isolated cardiac abnormalities, such as mild aortic stenosis; a similar proportion consider these candidates only if older than 50 years. Cigarette or marijuana smoking are infrequently criteria for exclusion, although 45% and 37% programs, respectively, require cessation 4 weeks prior to surgery. In addition to providing an overview of current practices in living kidney donor evaluation, our study highlights the importance of research evaluating outcomes with various comorbidities to guide practice.
(© 2020 The American Society of Transplantation and the American Society of Transplant Surgeons.)

Comment in: Am J Transplant. 2020 Dec;20(12):3279-3280. (PMID: 32506602)

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