Reasons and effects of the decline of willing related potential living kidney donors

Table 1 Definitions of terms used to describe the living donors at different stages of kidney donation including access, counseling, evaluation, acceptance, candidacy, and donation with kidney transplantation of related intended patients

Term	Definition
PLD	An individual who confirmed his willingness to donate a kidney to an intended patient at the initial counseling settings and was ready to start the evaluation for kidney donation, regardless of the commencement of the evaluation
Related PLD	PLD who had a relative intended patient with end-stage renal disease up to the 4th degree of genetic relatedness. Regardless of their genetic relatedness, the wife or husband of a recipient was considered a related PLD
Excluded PLD	PLD who was disqualified as a kidney donor and excluded from the process of kidney donation by KT team due to causes that disqualify candidacy to donate a kidney, such as medical, immunological, or financial causes
Regressed PLD	PLD who withdrew his decision of kidney donation at any stage after an initial confirmation of the donation decision and before the operation
Released PLD1	PLD who was still willing and completed or was still continuing the evaluation, but the related intended patient was withdrawn from KT preparation due to any cause
Candidate PLD	PLD who completed all the steps of evaluation and was finally accepted by the KT team for kidney donation, regardless of the later regression or release from donation
Accepted PLD	PLD who completed the evaluation without exclusion from kidney donation and was accepted for donation without release or regression from his willingness
LD	PLD becomes a LD when he succeeds in donating a kidney to his/her intended patient, which also means KT was achieved
Relatedness degrees and forms2	First degree: father, mother, son, daughter, wife, and husband. Second degree: brother, sister, grandfather, grandmother, grandson, and granddaughter. Third degree: nephew, uncle and aunt. Fourth degree: cousins

¹In this study, release of the donor meant that the donor became free from any commitment to donating a kidney because his relative intended patient was excluded, regressed, or died. In addition, the donor would not be allocated to another patient, as he/she was willing to donate to his intended relative only.

²Husband-wife couples were processed as first-degree related potential living donors when donations were planned between each couple. However, they may be genetically related or unrelated, relative to their premarriage relatedness. KT: Kidney transplantation; LD: Living donor; PLD: Potential living donor.