In Pakistan ; living related donors is the only mean of getting kidney transplanted. A 60 years old male with reversible global ischemia on Thalium scan and tripple positive proteinuria wants to donate his kidney to a 50 years old wife; whereas life expectancy in pakistan is 66 years for females and 64 years for males. should we proceed with the transplant?
It's challange. However this is your decision. In my opinion, you should do it.
I would quantify proteinuria and if above 1 gm, i would biopsy him first!
I would not choose this guy for kidney donation. Regardless of the age and risk of surgery, according to definition of CKD, he has CKD and should be managed and evaluated for proteinuria in trems of quality and quantity and the need for biopsy and treatment.
Its a very trick call.
Given the life expectancy of 64 and that he is 60 with global hypokinesia, donating to his spouse will all need to be considered.
Can you quantify the proteinuria with a 24 hour collection as well as an albumin/creatinine ratio?
Nalaka Gunawansa Yes we can request for both .
thank you all for your responses.
I will update you on the decision
regards
Thanks Uzair for asking this question.
First we should define risks.It looks like he has IHD with proteinuria the cause of which is not clear. Bearing in mind the 'do no harm' principle, I will not proceed unless I have answers to these questions.
I will be inclined not to consider this donor based on limited info we have so far.
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