title: Practice patterns in evaluation of living kidney donors in United Network for Organ Sharing-approved kidney transplant centers.
abstract: BACKGROUND
  The current pattern of evaluation for living kidney donors was investigated.
  
  
  METHODS
  We designed a 37-question electronic survey to collect information about living kidney donor evaluation. Of the 181 United Network for Organ Sharing (UNOS)-approved centers, 72 responded. Survey responses were coded and downloaded into SPSS. Data was expressed as means and standard deviations or the percentage of centers with specific responses.
  
  
  RESULTS
  66% of the centers used a cut-off of <80 ml/min for exclusion of living kidney donors. 24-hour urine measuring creatinine clearance (CrCl) was the most common screening method for glomerular filtration rate (GFR) assessment in potential living donors. 56% of the centers excluded donors with blood pressure (BP) >140/90, whereas 22.7 and 7.1% excluded patients with pre-hypertension with a cut-off BP of 130/85 and 120/80, respectively. 66% of the centers used 24-hour urine creatinine to assess for proteinuria. 20% of the centers accepted living kidney donors with microalbuminuria and 84% accepted patients with a history of nephrolithiasis. 24% of the centers reported use of formal cognitive testing of potential living donors.
  
  
  CONCLUSIONS
  There were significant variations in exclusion criteria based on GFR, history of kidney stones, body mass index, BP and donors with urinary abnormalities. The definitions for hematuria and proteinuria were variable. There is a need for uniformity in selection and for a living donor registry. We also recommend raising the cut-off for estimated GFR to 90 ml/min to account for 10-15% overestimation when CrCl is used.
authors.affiliation: SUNY Downstate School of Medicine, Brooklyn, NY, USA.
authors.forename: Amarpali
authors.initials: A
authors.lastname: Brar
authors.forename: Rahul M
authors.initials: RM
authors.lastname: Jindal
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Abbott
authors.forename: Frank P
authors.initials: FP
authors.lastname: Hurst
authors.forename: Moro O
authors.initials: MO
authors.lastname: Salifu
mesh_terms: D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires