Altruistic living renal transplantation.

Living donor renal transplantation can not only reduce the increasing gap between demand and supply of renal transplants, but when compared with cadaveric renal transplants can also allow better results, particularly in the long-term. With the exception of HLA-identical siblings, there are no differences in long-term graft survival between HLA-related and HLA-unrelated living donor transplants. The possibility of a early transplantation, ideally before dialysis, can strongly improve patient and graft survival. The post-operative mortality and morbidity of the donor are minimal and may be furtherly reduced by an appropriate work-up. At present, there is no evidence that mononephrectomy in healthy subjects can expose them to an increased risk of renal failure, even in the long-term.