Genetic Screening in Kidney Transplant Candidate

Kidney transplantation is the preferred therapy for end‑stage renal disease, but genetic factors are increasingly recognised as critical in candidate evaluation, donor safety, and long‑term outcomes. This lecture will highlight how genetic screening informs transplant practice, with insights from Singapore relevant to nephrologists in Malaysia. Identifying monogenic causes of kidney failure can refine prognosis, guide immunosuppression, and reduce recurrence risk. Screening also uncovers syndromic or multisystemic conditions that influence peri‑operative risk and post‑transplant management. Genetic evaluation of potential living donors is particularly important, as undetected variants may predispose to future disease; cascade testing within families enhances donor safety and counselling. Case vignettes from Singapore illustrate how genetic findings have altered eligibility, donor selection, and family planning. Integration of genomic testing into national pathways, collaboration with the PRECISE programme, and recognition of barriers such as cost and underrepresentation of Asian populations highlight both innovation and ongoing challenges in regional transplant care.