Kidney transplantation from living unrelated donors.

Kidney transplant candidates increasingly are looking to their relatives, spouses, and even friends for a better chance at transplantation. The wait for a cadaver kidney might be 2-5 years. Although kidneys from well-matched family members have been transplanted with excellent results for many years, accepting living donors who are genetically unrelated to the patient has not been encouraged until recently. Results show that, among 1700 patients who received kidney transplants from living unrelated donors in the United States from 1995 through 1998, the one- and projected ten-year graft survival rates were 92% and 67%, respectively. These results are superior to the 87% and 50% rates for more than 26,000 cadaver kidney transplants during the same period. Risks to the donor are low (< 0.005% mortality and < 0.3% serious complications) but not absent. Thus, motivated spouses, friends, and adopted or step-family members can play an important role in the rehabilitation of patients who need a kidney transplant.