Choosing a donor for renal transplantation

Abstract

There is an increasing demand by patients with chronic renal failure to seek renal transplantation. As renal transplantation is not yet available in Sri Lanka and the patient having been sent off to another country for dialysis. The relatives make a bid to find a donor locally and quickly. We have sent donors for our patients from 1978 and the counseling has been directed to choosing a donor from within the family amongst relatives. There has been a recent increase in mass media advertisements about chronic renal failure. Fund collecting organisations are helping patient's to advertise for donors for kidneys like in the case of blood transfusions. Even financial inducements to prospective donors have been advertised. Wrong advice by doctors has been the major reason why patients advertise for donors when a relative could be promoted to donate a kidney. This paper highlights the criteria which must be utilised to select donors and specifically emphasises the need for doctors to encourage related Jive donor transplantation and discourage non-related live donor transplantation as the latter has the following disadvantages (I) bound to be less histocompatible and likelihood of increased post transplant rejections. (2) selling kidneys can become a business with involvement of middle men and is certainly ethically questionable. (3) This type of donor selection is not held with respect by international nephrological organisations and we would jeopordise any help we could get to augment any local renal transplantation programme in the future