Article: Genetic evaluation of living kidney donor candidates: A review and recommendations for best practices
Authors: Christie P Thomas, Reem Daloul, Krista L Lentine, Reginald Gohh, Prince M Anand, Hila Milo Rasouly, Asif A Sharfuddin, Johannes Schlondorff, Nancy Rodig, Margaret E Freese, Neetika Garg, Brian K Lee, Yasar Caliskan
Journal: Am J Transplant. 2023 Mar 1;S1600-6135(23)00305-2
The increasing accessibility and falling costs of genetic sequencing techniques has expanded the utilization of genetic testing in clinical practice. In living kidney donation, genetic evaluation has been increasingly used to identify genetic kidney disease in potential candidates, especially those of younger age. However, genetic testing on asymptomatic living kidney donors remains fraught with many challenges and uncertainties. Not all transplant practitioners are aware of the limitations of genetic testing, are comfortable with selecting testing methods, comprehending test results, or providing counsel, and many do not have access to a renal genetic counselor or a clinical geneticist. While genetic testing can be a valuable tool in living kidney donor evaluation, its overall benefit in donor evaluation has not been demonstrated and it can also lead to confusion, inappropriate donor exclusion or misleading reassurance. Until more published data is available, this practice resource should provide guidance for centers and transplant practitioners on responsible use of genetic testing in the evaluation of living kidney donor candidates.
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