Living Donor Contraindications

Certain medical conditions will result in a potential living donor being rejected for donation. Generally, these conditions, called “contraindications,” indicate that the potential donor is not healthy enough to donate or would be at risk themselves of kidney disease or other health issues now or in the future. The lists that follow are taken from medical guidelines proposed by the UNOS Living Donor Committee in an attempt to get UNOS participating transplant centers to have a more consistent and comprehensive approach to donor evaluation. While the proposals were not accepted, they provide an indication of the types of contraindications you would find at most transplant centers.

Absolute Exclusion Criteria

The following conditions would exclude a living donor candidate without any further evaluation:

  • Under age 18.
  • Hypertension blood pressure greater that 130/90 plus one of the following conditions: in someone younger than 50 years old, with evidence of end organ damage, non-Caucasian, or on three or more anti-hypertensive medications
  • Diabetes
  • Abnormal glucose tolerance test
  • History of thrombosis or embolism
  • Psychiatric contraindications [UNOS did not specify which conditions]
  • Obesity: Body Mass Index (BMI) greater than 35
  • Coronary artery disease
  • Symptomatic valvular disease [damage of heart valves]
  • Chronic lung disease with impairment of oxygenation or ventilation
  • Recent malignancy or cancers with long times to recurrence (e.g., breast cancer)
  • Urologic abnormalities of donor kidney
  • Creatinine clearance under 80 ml/min/1.73m2, or projected glomerular filtration rate (GFR) with removal of one kidney at 80 years old of under 40 cc/min/1.73m2
  • Peripheral vascular disease [diseases of blood vessels outside the heart and brain, usually a narrowing of vessels that carry blood to the legs, arms, stomach or kidneys.]
  • Proteinuria [blood in urine] greater than 300 mg in 24 hours
  • HIV, hepatitis C, or hepatitis B virus infection

Relative Exclusion Criteria

The following conditions may exclude a potential donor, subject to further evaluation:

  • Age between 18 and 21, and older age [UNOS did not specify] relative to the medical condition
  • Obesity (BMI between 30 and 35)
  • Kidney stones
  • Distant history of cancer
  • Past history of psychiatric disorder
  • Renovascular disease [blood flow in and out of the kidneys]
  • Thin basement membrane disease [an inherited disease that affects the glomeruli – the small blood vessels in the kidneys that filter wastes from the blood]
  • Prior valve surgery
  • Moderate cardiac valvular disease with otherwise normal echocardiographic findings [heart issues]
  • Mild sleep apnea without pulmonary hypertension

Keep in mind that policies and procedures vary from transplant team to transplant team. You should confirm the actual contraindications with your transplant team.