Donor selection
Cadaver organs are most commonly used. Donors are usually patients with irreversible brain stem damage who have no evidence of malignant disease. Ideally, once removed, the kidneys should be kept in ice for no more than 24 hours.
Living donors are used infrequently. Such donors should:
- be related to the patient - a parent or sibling; in the UK, donation from an unrelated adult requires approval from a Government appointed Committee
- be assessed as to the suitability of the kidney offered - usually intravenous urography and renal angiography are performed
Transplantation is more successful the more similar the immunogenetic pattern of donor and recipient. Close tissue matching at HLA class II loci appears to be important.
Reference
- Guidelines on Renal Transplantation; European Association of Urology (2018 update)
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