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Living Donor Kidney Transplant — RACP Adult Medicine MCQ

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HardNephrologyLiving Donor Kidney TransplantRACP Adult Medicine

A person approaching kidney failure has an ABO-compatible living donor and no contraindication to transplantation. What is the most important potential advantage of proceeding pre-emptively with living-donor transplantation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — It can avoid or shorten dialysis exposure and permits planned transplantation with generally superior graft outcomes

The best answer is “It can avoid or shorten dialysis exposure and permits planned transplantation with generally superior graft outcomes”. Living donation allows a planned operation, shorter cold ischaemia and often pre-emptive transplantation before dialysis, which is associated with better patient and graft outcomes. Compatibility lowers immunological risk but does not abolish rejection, immunosuppression or disease recurrence. Donor evaluation must remain independent because nephrectomy carries real short- and long-term risks.

Reference: Kidney Health Australia: Living kidney donation: https://kidney.org.au/resources/booklets/an-introduction-to-kidney-donation-by-live-donors-booklet/