The spouse as a donor in renal transplants.

TMost renal transplants performed in India are from live related donors. The mother is the most frequent donor. In India, the Transplantation of Human Organs Act, which was passed in 1994, allowed organ procurement from "near relatives" live donors. In the period between 1999 and 2003 we performed in our center 41 spouse to spouse transplants, and 356 transplants among the live genetically related. The two groups showed comparable mean creatinine at one (136 +/- 38 mumol/L vs. 151 +/- 53 mumol/L) and three years (136 +/- 41 mumol/L vs. 154 +/- 53 mumol/L). The spouse allograft recipients had 26% incidence of acute rejections vs. the genetically related recipients who had 22% incidence over a similar period. We believe that though spouse donated kidneys survive comparably with those from genetically related donors; strict criteria for their acceptance should be enforced considering the social background in India, in order to prevent exploitation of female spouses from coercion of donation. In addition to our results, we discuss our policy for accepting the spouse as a kidney donor.