Opinion Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Apr 18, 2021; 11(4): 88-98
Published online Apr 18, 2021. doi: 10.5500/wjt.v11.i4.88
Pre-emptive live donor kidney transplantation-moving barriers to opportunities: An ethical, legal and psychological aspects of organ transplantation view
David van Dellen, Lisa Burnapp, Franco Citterio, Nizam Mamode, Greg Moorlock, Kristof van Assche, Willij C Zuidema, Annette Lennerling, Frank JMF Dor
David van Dellen, Department of Renal and Pancreas Transplantation, Manchester University NHS Foundation Trust, Manchester M13 9WL, United Kingdom
David van Dellen, Department of Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, United Kingdom
Lisa Burnapp, Nizam Mamode, Department of Transplantation, Guy's and St. Thomas' NHS Foundation Trust, London SE1 9RT, United Kingdom
Franco Citterio, Department of Surgery, Renal Transplantation, Catholic University, Rome 00153, Italy
Greg Moorlock, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom
Kristof van Assche, Res Grp Personal Rights & Property Rights, University of Antwerp, Antwerp 2000, Belgium
Willij C Zuidema, Departments of Internal Medicine, Erasmus Medical Centre, Rotterdam CE 1015, Netherlands
Annette Lennerling, The Transplant Centre, Sahlgrenska University Hospital, Gothenburg S-413 45, Sweden
Annette Lennerling, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg S-405 30, Sweden
Frank JMF Dor, Imperial College Renal and Transplant Centre, Hammersmith Hospital, London W2 1NY, United Kingdom
Author contributions: van Dellen D, Lennerling A and Dor FJMF designed the research study; van Dellen D wrote the manuscript; all authors performed the research, have rad and approved the final manuscript
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: David van Dellen, FRCS, MD, Surgeon, Department of Renal and Pancreas Transplantation, Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, United Kingdom. david.vandellen@mft.nhs.uk
Received: September 21, 2020
Peer-review started: September 21, 2020
First decision: December 11, 2020
Revised: January 30, 2021
Accepted: March 12, 2021
Article in press: March 12, 2021
Published online: April 18, 2021
Core Tip

Core Tip: Live donor kidney transplantation (LDKT) is the optimal treatment for end stage renal disease (ESRD), particularly pre-emptively, prior to requirement for renal replacement therapy. There are a number of potential barriers and opportunities to promoting this: (1) National frameworks; (2) Health care providers and transplant programmes; (3) Societal norms/cultural expectations; (4) LKDT donors; And (5) Patients with ESRD. We recommend an approach where: Patients approaching ESRD are referred early; potential donors are prioritized; education regarding pre-emptive LDKT should be the norm; pre-emptive transplantation maximize benefit to potential recipients. Investment in infrastructure, increased awareness, and donor and recipient support is required.