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of an individual prior to donation 1. Renal Function Individuals with > 90 mL/min/1.73m2 are considered candidates for donation while those < 60 mL/min/1.73m2 are not. For those with renal function between these two levels, an individual clinical decision needs to be discussed with the transplant center. Renal function used in the assessment needs to be measured at least once given the wide variation noted with current GFR estimates. 2. Protein in the urine (proteinuria) Patients with significant proteinuria are not considered candidates for donation. Individuals with very small amounts of albumin in the urine may be considered acceptable donors at some transplant centers 3. Hematuria (blood in the urine) The presence of microscopic hematuria i.e., blood in the urine that is not visible to the naked eye, is usually considered as acceptable for a kidney donor, especially if a reversible underlying etiology can be identified. A kidney biopsy may be done on a donor with microscopic hematuria to rule out significant underlying kidney disease. 4. History of kidney stones Individuals with kidney stones who want to donate should be evaluated in the context of the likelihood of recurrence of kidney stones and its attendant complications. A single isolated instance of a kidney stone in the distant past, for example, would not be a reason to rule out a potential donor, if medical evaluation shows that they are at low risk for developing another stone. Individuals who have previously had bariatric surgery need to be screened for the risk of recurrent nephrolithiasis. 5. Hypertension The presence of hypertension is not an absolute contraindication for organ donation at this time at most centers. However, hypertension that is difficult to control, associated with end organ damage, or occurs in individuals with an elevated lifetime risk of ESRD can rule these individuals out as potential donors. For example, African Americans are at increased risk for kidney disease; African Americans with hypertension are usually not candidates to be organ donors. 6. Obesity Given the increasing prevalence of obesity and overweight individuals, this is a common consideration when evaluating donors. Obesity is not considered an absolute contraindication. However, there is an independent association between obesity and ESRD prompting most transplant programs to decline organ donation from individuals with a body mass index (BMI) of > 35 Kg/m2 . Some centers may choose stricter criteria. Transplant centers often require obese potential donors to lose weight prior to organ donation based on the total lifetime risk of ESRD.

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