Renal transplant from living donor. Experience of the Parma Center

BACKGROUND AND AIMS: The scarce availability of organs and the excellent results obtained using living donors, due to the improved degree of compatibility between donor and recipient, the short period of organ storage and the possibility of choosing the ideal surgical "timing", in the authors' opinion justify the use of living donors from a clinical and ethical-moral point of view. METHODS: Between April 1986 and December 1996 a 406 renal transplants were performed; of these, 10 patients received grafts from living donors. Preliminary screening consisted in a careful clinical and immunological evaluation to evaluate the operating risk, good compatibility with the recipient and the perfect bilateral function of the kidney. RESULTS: The 10 donors had no postoperative mortality or morbidity, no alterations of renal function, and no onset of hypertension and/or proteinuria in the immediate post-operative period or at a distance. The organ and patient survival rate (including a follow-up of between 2 and 54 months, mean 25 months) was 100%. CONCLUSIONS: The authors suggest that living donors represent a valid alternative in uremic patients. This therapeutic act must be carried out in complete respect for ethical, moral and legislative principles and must be based on a careful clinical selection to minimise the risks of donation and to guarantee the maximum benefit for the recipient. It is to be hoped that further improvements are made in immunodepressive treatment, and above all an appropriate increase in transplants from cadaveric donors, making the use of living donors superfluous since this practice maims a perfectly healthy individual.