Dr Melanie Wyld1,2, Dr Tess Cooper2, Dr Laura Smith2, Prof Kate Wyburn2,3
1Department of Renal and Transplant Medicine, Westmead Hospital, Westmead, Australia, 2University of Sydney , Sydney, Australia, 3Department of Renal and Transplant Medicine, RPA Hospital, Camperdown, Australia
Biography:
Melanie Wyld (B.Econ(Hons) MBBS MBA MPH PhD FRACP) is a nephrologist at Westmead Hospital and senior lecturer in clinical epidemiology at University of Sydney. She received her PhD in 2019 from the University of Sydney. She is a clinical researcher with research interest in living donor kidney transplantation. She is Chair of the Living Donation Clinical Working Group of TSANZ, Chair of ANZDATA Living Kidney Donor working group, and Chair of Equity Diversity and Inclusion Committee of the Australian and New Zealand Society of Nephrology.
Aim:
This study aimed to assess the availability and use of living donor guidelines among Australian nephrologists.
Background: Australia lacks a current national guideline for living donor evaluation, resulting in considerable variability in assessment practices across centres. Clear and consistent guidelines are vital for optimising donor safety, standardising practices, and maintaining equitable access to transplantation. Methods: Between February and April 2024, Australian nephrologists involved in living kidney donor assessment were invited to complete a 26-question online survey. Questions included participant demographics, and guideline availability and use. Data were analysed descriptively. Results: Thirty-three nephrologists (52% transplant nephrologists; 48% general nephrologists) participated. Forty-eight percent reported they have unit-specific guidelines in oral/shared knowledge form, 27% did not have unit-specific guidelines, and 21% had written guidelines. Ninety-one percent referred to some form of guideline when deciding on donor suitability: 88% consulted the KDIGO Living Donor Guidelines, 55% the archived CARI Guidelines, and 39% ANZKX Guidelines. Conclusion: Although most Australian nephrologists rely on established international guidelines such as KDIGO, there is inconsistency in how local guidelines are defined and maintained. The reliance on archived or external sources highlights the clear need for comprehensive, up-to-date national guidelines. Standardised, written protocols would reduce variability in donor assessments, enhance donor safety, and enable greater consistency across living kidney transplantation programs in Australia.
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