Abstract
Background From 2000-2014, 106 kidney donor nephrectomies from unspecified donors were performed at our center which resulted in 178 kidney transplants by performing domino paired procedures. Five of these donors (4,7 %) had a life-threatening disease. Methods All five donors underwent the hospital's standard pre-transplantation donor screening procedure. Additionally, motivation to donate and psychological stability were assessed by a psychologist using in depth interview techniques and a psychological complaints questionnaire. Post donor nephrectomy follow-up consisted of self-report questionnaires and hospital visits. Results One patient had cerebral and caudal ependymomas, one had severe and progressive emphysema, two had Huntington's disease and one had a grade 2 oligodendroglioma. The psychological screening revealed genuine motivation, adequate risk perception, and normal sense of reality. The five donor nephrectomies made 9 kidney transplantations possible. All donors were satisfied with the donation procedure. Three donors died during follow-up as a result of their disease. Conclusion Patients with a life-threatening disease may have a genuine motivation to become an unspecified living kidney donor. In the absence of medical and psychological contra-indications and in view of their self-reported satisfaction with the donation we feel it ethically justified to accept their offer.
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