NONRELATED LIVING-DONOR KIDNEY-TRANSPLANTATION - MEDICAL AND ETHICAL ASPECTS

Several patients with end-stage renal disease went to Bombay for renal transplantation from nonrelated living donors and then returned to Tu rkey for posttransplantation follow-up. The aims of this study are to evaluate the long-term results of renal transplantation from nonrelate d living donors in Turkish patients with end-stage renal disease and t o discuss the ethical and social aspects of nonrelated kidney donation . One hundred and twenty-seven patients (89 males, 38 females; mean ag e 38.1, range 17-63 years) were investigated retrospectively. None of the patients went to Bombay on our advice. All transplantations were p erformed between 1991 and 1995. The mean follow-up period after transp lantation was 34.2 (range 1-68) months. Graft survival rates were 85, 83, and 57% after 3 months and 1 and 5 years, respectively. Patient su rvival rates were 94, 93, and 92% after 3 months and 1 and 5 years, re spectively. Seven patients died within the first 3 months after the tr ansplantation. Surgical problems, infections, acute rejection, ciclosp orin nephrotoxicity, and hepatic problems were common complications. W e conclude that medical and surgical complications occur frequently in paid kidney transplantation, but most of these complications can be p revented by adequate preoperative management, and precautionary measur es should be taken to prevent commercialization of renal transplantati on before the spread of emotionally related living kidney donation.