Diabetes accounts for 44% of end-stage kidney disease in the US (per USRDS). Apparently, Mexico is no different.
What is different is that three Mexican researchers penned an article, published in a Medical Ethics journal, that criticizes the use of pre-diabetic folks as living kidney donors.
In prediabetic persons there are well known metabolic alterations that may compromise the long?term outcomes of the transplant if such donors are accepted. Even so, many of them are finally included because there are not enough donor candidates. Both, families and hospitals face the need to rapidly accept prediabetic donors before the clinical conditions of the recipient and the evolution of the disease exclude him/her as a transplant candidate; however, when using a kidney potentially damaged by prediabetes, neither the donor’s nor the recipient’s long term health is usually considered.
Considering the ethical implication as well as the clinical and epidemiological evidence, we conclude that prediabetic persons are not suitable candidates for kidney donation. This recommendation should be taken into consideration by Mexican health institutions who should rewrite their transplant protocols.
I’m so flabbergasted by this honesty, I hardly know what to say. In six years, I’ve never run across an American article of any sort that has even hinted at the idea that *some* folks just might not be suitable living donors. Contrarily, there seems to be a contest about who can “expand” the donor pool the most.
If someone is privy to an article from U.S. authors that actually cautions against taking someone’s kidney for transplant, please let me know.
Ferreira-Hermosillo A, Valdez-Martínez E, & Bedolla M (2014). Ethical issues relating to renal transplantation from prediabetic living donor. BMC medical ethics, 15 (1) PMID: 24935278