title: Should living kidney donor candidates with impaired fasting glucose donate?
abstract: As the kidney transplant waiting list grows, the willingness of transplant centers to accept complex donors increases. Guidelines for the evaluation of living kidney donors exist but do not provide clear guidance when evaluating the complex donor. Although few transplant centers will approve donor candidates with impaired glucose tolerance and most, if not all, will deny candidates with diabetes, many will approve candidates with impaired fasting glucose (IFG). Furthermore, the demographic of living donors has changed in the past 10 years to increasingly include more nonwhite and Hispanic individuals who are at greater risk for future diabetes and hypertension. IFG may be more of a concern in potential donors whose nonwhite and Hispanic ethnicity already places them at greater risk. We review the definition of diabetes, diabetes prediction tools, and transplant guidelines for donor screening and exclusion as it pertains to impaired glucose metabolism, and additional ethnic and nonethnic factors to consider. We offer an algorithm to aid in evaluation of potential living donors with IFG in which ethnicity, age, and features of the metabolic syndrome play a role in the decision making.
authors.affiliation: 330 Cedar Street, New Haven, CT 06520, USA.
authors.forename: Christine Buchek
authors.initials: CB
authors.lastname: Vigneault
authors.forename: William Stuart
authors.initials: WS
authors.lastname: Asch
authors.forename: Neera Kanhouwa
authors.initials: NK
authors.lastname: Dahl
authors.forename: Margaret Johnson
authors.initials: MJ
authors.lastname: Bia
mesh_terms: D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis*; D003661:Decision Support Techniques; D046148:Donor Selection; D005215:Fasting / Q000097:blood; D005260:Female; D044882:Glucose Metabolism Disorders / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors / Q000600:supply & distribution*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D014850:Waiting Lists
chemical_list: D001786:Blood Glucose