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What is Living Donor Kidney Transplantation?

The optimal treatment for end-stage renal disease — superior to dialysis in survival and quality of life. Living donor kidneys offer better long-term function than deceased donor kidneys due to shorter cold ischemia time and pre-emptive scheduling.

Why China?

• High volume: 309 Hospital, Tongji, and PUMC perform 100-300 transplants/year
• Cost: $35,000-$55,000 vs. $200,000-$400,000 in the US (1-year cost)
• Laparoscopic donor: 5-day hospital stay, return to work 4 weeks
• Generic immunosuppression: Tacrolimus, MMF at 1/5 US prices for lifetime maintenance

Who is a candidate?

• ESRD on dialysis or pre-dialysis (eGFR <15)
• Available living donor with compatible blood type and crossmatch
• No active infection or recent malignancy
• Adequate cardiac function

Outcomes

1-year graft survival: 96-98%. 5-year graft survival: 85-90% (vs 75-80% deceased donor). Donor 5-year survival: equal to age-matched general population.