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©2013 UpToDate ® Print Email Amsterdam forum guidelines for screening living potential kidney donors - 1 Donor evaluation Prior to donation, the live kidney donor must receive a complete medical and psychosocial evaluation, receive appropriate informed consent, and be capable of understanding the information presented in that process to make a voluntary decision. All donors should have standard tests performed to assure donor safety. Hypertension Patients with a BP >140/90 by ABPM are generally not acceptable as donors. BP should preferably be measured by ABPM, particularly among older donors (>50 years) and/or those with high office BP readings. Some patients with easily controlled hypertension, who meet other defined criteria, eg >50 years of age, GFR >80 mL/min, and urinary albumin excretion <30 mg/day may represent a low-risk group for development of kidney disease after donation and may be acceptable as kidney donors. Donors with hypertension should be regularly followed by a physician. Obesity Patients with a BMI >35 kg/m2 should be discouraged from donating, especially when other comorbid conditions are present. Obese patients should be encouraged to lose weight prior to kidney donation and should be advised not to donate if they have other associated comorbid conditions. Obese patients should be informed of both acute and long-term risks, especially when other comorbid conditions are present. Healthy lifestyle education should be available to all living donors. Dyslipidemia Dyslipidemia should be included along with other risk factors in donor risk assessment, but dyslipidemia alone does not exclude kidney donation. Acceptable donor renal function All potential kidney donors should have GFR estimated. Creatinine based methods may be used to estimate the GFR; however, creatinine clearance (as calculated from 24-hour urine collections) may under or overestimate GFR in patients with normal or near normal renal function. Calculated GFR values (MDRD and Cockcroft-Gault) are not standardized in this population and may overestimate GFR. A GFR <80 mL/min or 2SD below normal (based on age, gender, and BSA corrected to 1.73/m2) generally precludes donation. Urine analysis for protein A 24-hour urine protein of >300 mg is a contraindication to donation.

Calculated GFR values (MDRD and Cockcroft-Gault) are not standardized in this population and may overestimate GFR. A GFR <80 mL/min or 2SD below normal (based on age, gender, and BSA corrected to 1.73/m2) generally precludes donation. Urine analysis for protein A 24-hour urine protein of >300 mg is a contraindication to donation. Microalbuminuria determination may be a more reliable marker of renal disease, but its value as an international standard of evaluation for kidney donors has not been determined. BP: blood pressure; ABPM: ambulatory blood pressure monitoring; GFR: glomerular filtration rate; BMI: body mass index; BSA: body surface area; CT: computed tomography; ESRD: end-stage renal disease; HLA: human leukocyte antigen. Reproduced with permission from: Delmonico F; Council of the Transplantation Society. A Report of the Amsterdam Forum On the Care of the Live Kidney Donor: Data and Medical Guidelines. Transplantation 2005; 79:S53. Copyright © 2005 Lippincott Williams & Wilkins.