Objectives: Living donor kidney transplant is the preferred method of renal transplant in Pakistan as deceased donor transplant has not yet been estab-lished. However, many patients who are dialysis-dependent, particularly younger patients, lack suitable living related donors. We aimed to determine factors contributing to nonselection of donors for living related renal transplant in Pakistan.
Materials and methods: For this cross-sectional study, we included patients seen at the Sindh Institute of Urology & Transplantation Karachi, Pakistan) from March to November 2019. Potential donors were adult family members who accompanied patients with end-stage kidney disease to the clinic. Demographic and clinical information were recorded on predesigned proforma. After workup and baseline investigations had been completed, potential living related donors were selected. Factors leading to nonselection of donors were noted for those who did not qualify for donation. We used SPSS version 20 for analysis.
Results: During the study period, 253 potential donors (151 males, 102 females) with mean age of 35.68 ± 6.14 years were found to be ineligible for kidney donation. ABO incompatibility was the most common factor leading to nonselection (n = 101; 39.92%), followed by diabetes mellitus (n = 71; 28.06%), hypertension (n= 50; 19.76%), renal disease (n = 15; 5.92%), liver disease (n = 8; 3.16%), crossmatch positive (n = 5; 1.97%), and ischemic heart disease (n = 3; 1.18%). No differences were shown between potential male and female donors regarding factors leading to nonselection; diabetes was significantly more prevalent among those <40 years of age (P = .025).
Conclusions: ABO incompatibility, diabetes mellitus, and hypertension were the most common factors leading to nonselection of potential donors in living related kidney transplant. More efforts are needed to expand the donor pool by considering second- or third-degree relatives to tackle the scarcity of organs for transplantation.