Living Kidney Donation: Evolution of Strategies

Renal transplantation (RT) represents the best therapeutic option for patients with end-stage renal disease (ESRD), providing the best outcomes for survival, quality of life, and cost-effectiveness [1]. The widening gap between the recipients waiting for RT and the number of available kidney donors has led to annual expansion of the waiting list and dramatic increase in the morbidity and mortality due to the long waiting times for patients on dialysis. The living kidney donation (LKD) has become increasingly important in recent years due to decrease in the number of deceased kidney donors. There has been significant increase in the number of LKD over past decade due to enhancement of the education of the donors and recipients about LKD, introduction of minimally invasive surgical techniques of donor nephrectomy, expanded criteria for donor acceptance, informed consents, rigorous follow-up regimens, blood group ABO-incompatible (ABOi) and positive cross-match transplants and non-directed altruistic donations [2]. This editorial summarises the evolution of practice that has taken place over past six decades to encourage living kidney donation.