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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Dec 18, 2025; 15(4): 102555
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.102555
Published online Dec 18, 2025. doi: 10.5500/wjt.v15.i4.102555
Expanding boundaries: The evolution and future of living donor kidney transplantation
Ileana Lulic, Dinka Lulic, Iva Bacak Kocman, Damira Vukicevic Stironja, Gorjana Erceg, Iva Majurec, Kristina Medved, Jadranka Pavicic Saric, Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Merkur, Zagreb 10000, Croatia
Dinka Lulic, Immediate Medical Care Unit, Saint James Hospital, Sliema SLM-1030, Malta
Author contributions: Lulic I, Lulic D, Bacak Kocman I, Vukicevic Stironja D, Erceg G, and Pavicic Saric J designed the manuscript's original draft; Lulic I, Lulic D, Bacak Kocman I, Vukicevic Stironja D, Majurec I, Medved K, and Pavicic Saric J performed the literature review and data analysis; Lulic I, Lulic D, and Pavicic Saric J participated in the conceptualization of this manuscript and performed manuscript supervision and project administration; Majurec I and Medved K reviewed and edited the manuscript original draft; all of the authors approved the final version of the manuscript to be published.
Conflict-of-interest statement: There are no conflicts of interest to this manuscript.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ileana Lulic, MD, Postdoctoral Fellow, Department of Anesthesiology, Intensive Care and Pain Medicine, Clinical Hospital Merkur, Zajceva 19, Zagreb 10000, Croatia. ileanalulic@gmail.com
Received: October 22, 2024
Revised: March 23, 2025
Accepted: April 11, 2025
Published online: December 18, 2025
Processing time: 393 Days and 17 Hours
Revised: March 23, 2025
Accepted: April 11, 2025
Published online: December 18, 2025
Processing time: 393 Days and 17 Hours
Core Tip
Core Tip: Living donor kidney transplantation (LDKT) offers favorable early graft outcomes and improved donor safety through advances in selection, immunologic matching, and perioperative care. Donor kidney laterality, right vs left, remains a key technical consideration, with right-sided nephrectomy linked to higher early complication rates but comparable long-term outcomes. Rather than using laterality as an isolated quality indicator, this editorial calls for its assessment within a broader surgical and clinical context, integrating anatomical complexity, procedural planning, and center-specific expertise to support informed, case-specific decision-making in LDKT.