Due to the current shortage of donors, living kidney transplantation has become a very important channel to provide donors. In the United States, the number of living kidney transplants accounts for about 50% of the total number of kidney transplants and has achieved very good results. According to the current regulations in China, only living kidney transplantation between relatives can be performed. Living kidney transplantation between relatives refers to allogeneic kidney transplantation between donors and recipients with close blood relationship, including kidney transplantation between parents and children, and between siblings as donors and recipients. Kidney transplantation between spouses is a special type of living kidney transplantation that includes a wife donating a donor kidney to her husband and a husband donating a donor kidney to his wife. Compared with cadaveric kidney transplantation, living kidney transplantation between relatives has the following advantages? 1. Avoid long waiting time. Due to the current shortage of donors, more and more patients are waiting for kidney transplantation and need to wait longer and longer. In the United States, the average waiting time is 4 years, while in China, the waiting time is also gradually extended to 2 to 3 years. During the waiting process for kidney transplantation, inadequate dialysis may lead to hypertension, heart disease, anemia and infectious diseases such as infectious hepatitis C, raising the risk of surgery and reducing the survival rate of human kidney, while many uremic patients are waiting for various complications causing the loss of kidney transplantation opportunity. In contrast, living relative kidney transplantation can be performed electively, avoiding a long wait and improving the chances of successful surgery. 2. Convenient surgery arrangement: living relative kidney donor can schedule the surgery according to the recipient’s physical condition, so that there is no need to wait for a long time and increase the treatment cost or even lose the transplantation opportunity. On the contrary, cadaveric kidney transplantation is an emergency operation because it is difficult to predict when a suitable kidney source will be available. In recent years, trans-laparoscopic kidney harvesting and retro-laparoscopic donor kidney removal have been performed at home and abroad, which have better safety and effectiveness. For the donor, compared with open surgery, the postoperative pain is light, the recovery time is short, and the long incision scar is avoided. 3. Good histocompatibility between donor and recipient, low chance of postoperative rejection, and small amount of postoperative immunosuppressant. Due to the law of genetics, the difference of human histocompatibility antigens between relatives is small and the suitability of tissue mating is high, so the chance of rejection after surgery is low, and the dose of immunosuppressant will be low, and the side effects of good mating and immunosuppressant will be reduced, so the survival time of transplanted kidney will be prolonged, and international and our transplantation center experience suggests that living kidney transplantation has better The international and our transplant center experience suggests that living kidney transplantation has a better near and long-term survival rate. It also reduces the financial burden due to the lower dose of immunosuppression. The longest surviving relative kidney transplant in the world has survived for 40 years, which is difficult to achieve with an unrelated cadaveric kidney. 4.Promote emotional communication: Kidney donation is an act of love and courage, reflecting the spirit of love and mutual help in the donation process, which will enhance the feelings between the donor and the recipient, allowing love to be sublimated, life to be extended, and family and family to be more harmonious. 5, good quality of the donor kidney: the quality of the donor kidney directly affects the transplantation effect, and the quality of the donor kidney mainly depends on the length of thermal ischemia and cold ischemia time. The ischemic time of the donor kidney refers to the period of time between 0 ℃ and 4 ℃ before the perfusion of the kidney preservation fluid after the kidney is isolated, and the cold ischemic time refers to the time between the perfusion and the transplantation into the patient’s body. The thermal ischemia time is particularly important. The living donor kidney significantly reduces the thermal ischemia time (1-2 minutes), minimizes ischemia-reperfusion injury, ensures good donor kidney quality, and enables early recovery of graft function after surgery. With good donor kidney quality, renal function can be restored to normal early after surgery, and the possibility of acute tubular necrosis is extremely low; a comprehensive physical examination of the patient is performed before the operation of living relative donor kidney to understand whether there are anatomical variations in the donor kidney artery, vein, renal pelvis and ureter, thus ensuring the integrity of the donor kidney taken. 6, the recipient’s short-term and long-term post-operative outcomes are better than cadaveric kidney: living relative kidney transplantation can improve the long-term survival rate of living relative kidney transplantation due to excellent mating, good donor kidney, shorter waiting time and lower dose of immunosuppressant after surgery, foreign data statistics, more than half of the relative donor kidney survival time is 19.5 years, much higher than the 12.5 years of cadaveric kidney. However, there are huge risks associated with relative kidney transplantation, mainly in the following areas: 1. The donor is a physically healthy person, relative living kidney transplantation violates the principle of “harming a healthy person for the health of another”, and the donor has to bear the surgical risks during the operation, which are reported to be 3/10,000 to 10/10,000 at home and abroad. /Although the incidence is low, it is 100% in individuals and requires full consideration of the donor and family members, and the right to stop the donation at any time. 2, transplant recipients of kidney transplantation during and after surgery are at risk, although relatives of living kidney transplantation match better, but still can occur rejection, or even transplantation failure, resulting in transplanted kidney failure, return to dialysis, this end often brings great stress and psychological trauma to the donor. There are also recipients who develop serious infections after transplantation, leading to a life-threatening crisis, which brings more psychological trauma to the donor, who needs to be well informed between donations. 3, donor kidney surgery is a larger surgery, there are many post-operative complications, including wound pain, increased blood pressure, etc., the obvious ones can affect life and work. Due to the decline in kidney reserve function, so after donation can not participate in heavy physical labor, but also to avoid staying up late, work overworked and other situations, the nature of the work has a certain impact. While living relative kidney transplantation has many advantages, there are also many risks. Therefore, living relative kidney transplantation is a cautious and high-risk act, and is a last resort option. The following principles should be followed for living relative kidney transplantation: 1. the principle of total voluntariness, no family members or financial pressure to donate; 2. the principle of total gratuitousness, no financial requirements can be met by relatives donating kidneys; 3. the principle of caution, this is a risky surgery and may lead to life-threatening, so the decision should be made carefully.