Researchers have produced a new online tool to analyze one’s risk for donating a kidney.
Krista Lentine, M.D., Ph.D., professor of internal medicine at Saint Louis University, and Amit Garg, M.D., Ph.D., professor of medicine at Western University in Ontario, Canada co-chaired a work group of international practitioners that published “Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors” in Transplantation and the New England Journal of Medicine and posted their resulting online risk projection tool at www.transplantmodels.com/esrdrisk.
The ESRD in the projection toll’s name is an acronym for End Stage Renal Disease. The research group is called the Kidney Disease: Improving Global Outcomes (KDIGO) international work group.
The guideline and projection tool reflect a new framework for donor candidate evaluation grounded in the simultaneous consideration of demographic (i.e., age, sex and race) and health characteristics (e.g., kidney function, blood pressure, body mass index, smoking status) on the candidate’s risk of serious adverse outcomes after donation.
“The altruistic, life-saving act of donation warrants ongoing pursuit of the highest standards of evidence to ensure that potential risks are identified and considered in selection and informed consent, and that care is optimized to minimize risks,” said Lentine.
To date, clinical practice guidelines and regional policies recommended consideration of one risk factor at a time in the assessment of living donor candidates – for example, separate candidacy criteria are offered for blood pressure, obesity and smoking that regard each of these factors in isolation. Poor understanding of comprehensive risk has led to inconsistent donor selection practices, the researchers claim.
African Americans are the largest group of minorities in need of an organ transplant, according to the U.S. Department of Health and Human Services (HHS). African Americans have higher rates of diabetes and high blood pressure than whites, increasing the risk of organ failure. African Americans make up 13 percent of the population, but 34 percent of those waiting for a kidney and 25 percent of those waiting for a heart, according to HHS.
