Use of Living Donors for Renal Homotransplantation.

The use of volunteer living donors to patient (Table 1). Of the 40 donors, 27 were either provide kidneys for renal homotransplantaParents or siblings. The other 13 were not genetically related to the recipient. In the last group, there were has many and lega1 imthree wives, nine convicts, and one volunteer who plications. The infliction of major operative responded to a public appeal (Table h3uma upon healthy well-motivated donors A mass of experimental evidence can be cited in cannot be dismissed lightly since the chance support of the position that homografts are tolerated for ultimate viability of the homograft in its better and for a longer period of time if the donor new environment is highly speculative. the and recipient subjects are closely related. In humans a similar but less incontrovertible tendency has been long run, justification for continued use Of noted.' In our experience, the incidence of success volunteer donors depends upon the demonhas been greatest with mother-to-offspring donastration that the donor operation carries a tions, next with siblings, and lowest with donations negligible risk and that the benefit for the from unrelated volunteers. recipient patients is substantial and preIn discussing kidney donations with those who wish to volunteer, an objective account is given concerning the risk to themselves and the chances In this communication, data will be of salvaging the recipient patient. The sacrifice of analyzed concerning the risk involved to the the donor is so great that he must not commit himself donor, based upon experience with 40 pato participation without realizing that there is a tients. addition, a detailed account of the significant chance of early transplant failure. Furthermore, he must understand that the results donor 'peration be provided' In the in late stages of homotransplantation are not known existing literature on renal transplantation, any degree of this phase of technical care has never been When possible, the major blood groups in the fully described, although it is evident that donor and recipient patients are matched. When this both the operative risk and the quality of the is not feasible, donations are accepted from patients with different blood types, provided they conform to homograft Obtained are dependent upon the the general scheme of tissue transfer in which 0 is details of nephrectomy. the universal donor and AB+ is universal recipient.' The potential donor is given a thorough general Case Material medical examination. Unsuspected pathologic findings of importance are sometimes uncovered. One Forty living donors were used for the treatment of 39-year-old lady was found to have a large serous the first 37 cases of renal transplantation, including cystadenoma of the ovary (Fig 1). Another patient two identical twins. Their ages ranged from 18 to 53 (Table 1). TABLE 1.-Donor Age and Relation to R(-ri/vm/ Selection of Living Donors.-Priority is given to those volunteers having genetic relationship to the Age 0-19 20-28 30-38 40-48 48+ Read before the 71st Annual Session of the Western Surgical Association, Galveston, Tex, Nov 0 0 1 0 1 0 0 5 3 0 8 21-23, 1963. Brother 1 7 3 2 1 1 4