Abbasi MT, Prasad GVR. Donor medicine: An emerging field in nephrology. World J Nephrol 2026; 15(3): 121522 [DOI: 10.5527/wjn.121522]
Corresponding Author of This Article
G V Ramesh Prasad, MBBS, PhD, Professor, Kidney Transplant Program, St. Michael’s Hospital, 61 Queen Street East, 9th Floor, Toronto M5C 2T2, Ontario, Canada. ramesh.prasad@unityhealth.to
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
review-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Nephrol. Sep 25, 2026; 15(3): 121522 Published online Sep 25, 2026. doi: 10.5527/wjn.121522
Donor medicine: An emerging field in nephrology
Muhammad Tanzeel Abbasi, G V Ramesh Prasad
Muhammad Tanzeel Abbasi, G V Ramesh Prasad, Department of Medicine, University of Toronto, Toronto M5C 2T2, Ontario, Canada
Muhammad Tanzeel Abbasi, G V Ramesh Prasad, Kidney Transplant Program, St. Michael’s Hospital, Toronto M5C 2T2, Ontario, Canada
Author contributions: Abbasi MT and Prasad GVR contributed equally to the collection of data and writing of the manuscript.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: G V Ramesh Prasad, MBBS, PhD, Professor, Kidney Transplant Program, St. Michael’s Hospital, 61 Queen Street East, 9th Floor, Toronto M5C 2T2, Ontario, Canada. ramesh.prasad@unityhealth.to
Received: March 26, 2026 Revised: June 5, 2026 Accepted: July 9, 2026 Published online: September 25, 2026 Processing time: 140 Days and 5.1 Hours
Abstract
Donor medicine is an emerging field in nephrology. Medical specialties develop from how organ systems organize, new technologies, or groups of diseases. Donor medicine stands at the intersection of medicine, surgery, public health, and the humanities, but unlike recipient medicine does not involve immunology. Living kidney donors (LKDs) start from a position of excellent health and normal predicted lifespan. Nephrologists have a special obligation to follow altruistic LKDs over the long-term, even though the safety of donation has been generally well established. This paper summarizes the physiological changes associated with LKD surgery, resulting from reduced nephron mass, glomerular hyperfiltration, and blood pressure elevation, to the health risks associated with LKD surgery including chronic kidney disease, proteinuria, hypertension, preeclampsia, adverse psychology, and financial burden. Successful kidney transplantation does not simply mean performing a large number of transplants or even achieving a high long-term recipient graft or patient survival rate. Successful kidney transplantation means that the LKD also performs well in a situation that nature never intended for them. Placing long-term donor health into better perspective will help to provide a framework for establishing donor medicine as a distinct medical specialty, which will in turn encourage LKD and increase organ donation rates.
Core Tip: Even though living kidney donation has existed for over 60 years, there has been limited systematic collection of information related to the long-term health of donors. Establishing a distinct medical specialty called donor medicine is a moral obligation that will also encourage more living kidney donation. Donor medicine will also provide a framework for donor-centered care and rigorous long-term follow up.
