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Editorial |

Understanding Rare Adverse Outcomes Following Living Kidney Donation

John S. Gill, MD1,2,3; Marcello Tonelli, MD4,5,6
[+] Author Affiliations
1Division of Nephrology, University of British Columbia, Vancouver, Canada
2Center for Health Evaluation and Outcomes Sciences, University of British Columbia, Vancouver
3Tufts-New England Medical Center, Boston, Massachusetts
4Department of Medicine, University of Alberta, Edmonton, Alberta
5Department of Public Health Sciences, University of Alberta, Edmonton, Alberta
6Interdisciplinary Chronic Kidney Disease Collaboration, Calgary
JAMA. 2014;311(6):577-579. doi:10.1001/jama.2013.285142.
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A new era in the treatment of patients with end-stage renal disease (ESRD) was heralded by the first successful kidney transplant in 1954—a living donor transplant between identical twins. A 23-year-old man donated his kidney to his brother and survived until the age of 79 years with a solitary kidney.1 Today, kidney transplantation is the treatment of choice for patients with ESRD, and the shortage of transplantable organs is the major issue limiting the field.2 Both living and deceased organ donations are recognized as critical practices to meet the increasing demand for kidney transplants. The availability of a living donor allows for timely transplants and is associated with superior outcomes compared with dialysis or transplants from deceased donors. In developing countries, where chronic dialysis is too expensive for most families (and the infrastructure to support deceased donation is unavailable), living donor transplant is often the most feasible treatment option. In 2011, living donors provided 42.5% of all transplanted kidneys, with more than 31 000 procedures performed in more than 100 countries.3

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