I’m 37 years old male and awaiting a second transplant as my first transplanted kidney (from an unrelated donor) has stopped functioning after 8 years. I have got registered for a cadaveric kidney and my sister too has volunteered to donate her kidney. We are a 100% HLA match. Her corrected creatinine clearance is 82.5 ml/min/1.73m2 and serum creatinine 0.8 mg/dl and GFR is 76.She is 34 years. She is a healthy person with no diabetes, cholesterol or high BP. My HLA class 1 PRA is 7 % and HLA Class II PRA is 91%. If I were to select between a cadaveric kidney and my sister’s kidney, what would be the best option for me? Is her kidney function sufficient to cater me as well for her, once she donates one kidney?

The question that you ask is very informed and also very complex.  If you opt for a cadaver kidney transplant, your waiting time is likely to be very long, depending on the kidney center where you are listed. The living related donor with 100% matching HLA antigens, is most likely to be successful, but sometimes transplanting small kidneys from women into larger men does not supply them with enough kidney tissue to maintain long term function.    Your sister will be left with lower kidney function as well but this is commonly sufficient for a smaller female.  I do not believe I can offer an opinion, but you should discuss your concerns with your transplant nephrologist, who knows your history and current medical status.  It is best for you to think this problem through with someone who knows you and your medical history.

 

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