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Krista L. Lentine, Andrew S. Levey, and Amit X. Garg

Since the advent of the successful practice of living donor kidney transplantation more than 60 years ago, over 150,000 healthy persons in the United States have donated a kidney to help a family member, a friend, or even a stranger. Currently, more than 30,000 living kidney donations are performed worldwide each year. Living donor transplantation is clearly established as the best treatment option for kidney failure, offering patients the best chance of long-term dialysis-free survival, with a better quality of life, at lowest costs to the healthcare system. However, despite the tremendous benefits to recipients and society, the outcomes in