The practice and ethics of live kidney donationsin israel

Background: From 2015-2017, 65% of all kidney donations in Israel were live donations. The authors of the present study, doubtful as to whether the risks attached to live donation had been sufficiently assessed and protected against, conducted a questionnaire survey of 91 Israelis who had donated a kidney. Method: The questionnaire asked about the content of the pre-donation process, if and how the risks had been explained to donors, post-donation illness/complications and the medical follow-up.Also, whether the donors felt supported, confident and well-advised. Results: Creatinine levels rose significantly post-donation, and highest in the youngest (18-29) age group. None of the donors were followed-up by a nephrologist, but by their GP only, and none had more than 2 follow-up checks. None was referred to a nephrologist for treatment or monitoring despite the raised creatinine levels. The risk information the donors received also reveals gaps and inadequacies. Conclusions: The authors propose recommendations to make the live donation process, more rigorous, more cautious, better followed-up and more strongly research-based. Equally important is to take vigorous action to multiply the number of deceased donations. Each deceased donation means one less live donation and so the less harm to healthy persons.