title: The Irish living kidney donor program - why potential donors do not proceed to live kidney donation?
abstract: BACKGROUND
  Living donation is not only a method to increase access to kidney transplantation but can also offer superior outcomes. We report the experience of the living donor (LD) program in the Republic of Ireland and explore reasons why potential donors do not proceed to live donation.
  
  
  METHODS
  Retrospective cohort study of all potential donors from January 2000 to March 2014 who presented wishing to undergo donor work-up and their subsequent outcomes.
  
  
  RESULTS
  A total of 956 donors for 496 recipients contacted the live kidney donation program of which 883 potential donors proceeded to the initial stage of assessment. The donor dropout rate at this stage was 64.2% (614/956 potential donors did not proceed to further evaluation). Thereafter, 269 (28.1%) donors underwent further assessment by the multidisciplinary team. In total, 93 (9.7%) donors were declined following this assessment with 176 (18.4%) donors ultimately proceeding to live kidney donation. The major reason for declining a donor was a medical contraindication (n = 63, 67.7%). In term of recipients, 54.2% (n = 269/496) had a potential donor proceed for further assessment of which 65.4% (n = 176/269) ultimately proceeding to live donation.
  
  
  CONCLUSIONS
  Further evaluation of the declined donor group is warranted to allow for expansion of the LD program.
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Dervla M
authors.initials: DM
authors.lastname: Connaughton
authors.affiliation: The National Histocompatibility and Immunogenetics Service for Solid Organ Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Grainne
authors.initials: G
authors.lastname: Harmon
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: Cooney
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Williams
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: O'Regan
authors.affiliation: The National Histocompatibility and Immunogenetics Service for Solid Organ Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Derek
authors.initials: D
authors.lastname: O'Neill
authors.affiliation: Transplant Coordinator Services, Department of Kidney Transplantation and Urology, Beaumont Hospital, Dublin, Ireland.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Cunningham
authors.affiliation: Transplant Coordinator Services, Department of Kidney Transplantation and Urology, Beaumont Hospital, Dublin, Ireland.
authors.forename: Aileen
authors.initials: A
authors.lastname: Counihan
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Patrick
authors.initials: P
authors.lastname: O'Kelly
authors.affiliation: Department of Psychiatry, Beaumont Hospital, Dublin, Ireland.
authors.forename: Siobhan
authors.initials: S
authors.lastname: McHale
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Mark
authors.initials: M
authors.lastname: Denton
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Conall M
authors.initials: CM
authors.lastname: O'Seaghdha
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Colm
authors.initials: C
authors.lastname: Magee
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Peter
authors.initials: P
authors.lastname: Conlon
authors.affiliation: Department of Kidney Transplantation and Urology, Beaumont Hospital, Dublin, Ireland.
authors.forename: Dilly
authors.initials: D
authors.lastname: Little
authors.affiliation: The National Histocompatibility and Immunogenetics Service for Solid Organ Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: Keogan
authors.affiliation: Department of Nephrology and Transplantation, Beaumont Hospital, Dublin, Ireland.
authors.forename: Declan G
authors.initials: DG
authors.lastname: de Freitas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007494:Ireland; D007677:Kidney Function Tests; D016030:Kidney Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D018579:Patient Selection; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012307:Risk Factors; D009927:Tissue and Organ Procurement / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: donor assessment; kidney transplantation; living donors; renal transplant; transplant immunology