I was informed today that the Transplant Team has denied me being able to donate a kidney to my brother. The reason they gave was that I had an elevated fasting blood sugar of 114 along with my family history of diabetes. I am the only one in my family who doesn’t have diabetes. My question is, why can’t I have the choice to donate a kidney? What happens if my brother never gets a kidney due to how long the list of recipients is? Shouldn’t it be my choice? Couldn’t stress be a big factor that causes my sugars to be elevated all of a sudden? Can I at least ask to be retested?

Each transplant center determines who will and who will not be a kidney donor. There are no nationwide accepted guidelines for transplant centers to follow.  It is generally felt that if someone has a risk of developing diabetes, there are a number of studies that suggest that diabetic kidney disease progresses more rapidly in someone with a single kidney than someone with two kidneys.  Hence, it is common to exclude living donors who are at risk for diabetes or who have so-called “pre-diabetes”.  You can certainly ask to be re-evaluated, but the center may decline to do so if they have made a decision already.  The goal of living donation is to “do no harm” while trying to benefit the patient who needs a kidney.  You have the right ask for re-evaluation, but this cannot be guaranteed.

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