Profiling Live Kidney Donors in America

The past two decades ushered in numerous clinical innovations in living-donor kidney transplantation (LDKTx) and an impressive increase in the volume of living-donor transplants. In this issue of CJASN , Davis and Cooper (1) review the rapid changes in the clinical profile of live donors that took place during that period. Their data suggest that growth in live donation was also facilitated by accepting donors who—like many Americans—are obese or uninsured or have hypertension. These donors are more often members of ethnic minorities, such as black individuals, and have an elevated risk for kidney disease. Davis and Cooper argue for more intensive efforts to ascertain detailed outcomes among these worrisome groups. However, the long time-horizon of plausible hazard poses challenges to answering the pressing question of whether donor nephrectomy is reasonably safe for all of our donors.Recent innovations provide plenty of reasons to be optimistic about LDKTx. Today, transplant centers can leverage a wide array of new tools and knowledge that did not exist 20 …