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Background: Living kidney donation has been advocated as a means to ameliorate the chronic shortage of organs for transplantation. Significant rates of comorbidity and familial risk for kidney disease may limit this approach in the local context; there is currently limited data describing living donation in Africa. Methods: We assessed reasons for non-donation and outcomes following donation in a cohort of 1208 ethnically diverse potential living donors evaluated over a 32-year period at a single transplant centre in South Africa. Results: Medical contraindications were the commonest reason for donor exclusion. Black donors were more frequently excluded (52.1% vs. 39.3%; p<0.001), particularly for medical contraindications (44% vs. 35%; p<0.001); 298 donors proceeded to donor nephrectomy (24.7%). Although no donor required kidney replacement therapy, an estimated glomerular filtration rate below 60 ml/min/1.73 m2 was recorded in 27% of donors at a median follow-up of 3.7 years, new onset albuminuria >300 mg/day was observed in 4%, and 12.8% developed new-onset hypertension. Black ethnicity was not associated with an increased risk of adverse post-donation outcomes. Conclusion: This study highlights the difficulties of pursuing live donation in a population with significant medical comorbidity, but provides reassurance of the safety of the procedure in carefully selected donors in the developing world. [ABSTRACT FROM AUTHOR]

Atopy can manifest in childhood as infantile eczema (atopic dermatitis), allergic rhinitis and asthma. In practice, it is critical to identify the offending allergen in atopic individuals. This will not only influence therapeutic interventions, but may also have a significant impact on the individual's quality of life. The most common clinical test for allergy detection is the introduction of an allergen directly into the skin in the form of a skin-prick test. Skin-prick testing is recommended in the diagnostic workup for allergies because it is reliable, safe, convenient, inexpensive, minimally invasive, and has the advantage of multiple allergen testing in one, 15- to 20-minute, test. Skin-prick testing can be performed from birth onwards. Although there is a small risk of developing anaphylaxis, the test remains safe to perform in a consultation room or at the patient's bedside. Worldwide, a skin-prick test remains the test of choice for allergy because of its convenience and cost-effectiveness. A globally accepted guideline for skin-prick testing is still lacking and would be beneficial to both patient and physician. [ABSTRACT FROM AUTHOR]