Pamela is a 57 year old female whom you have followed for 10 years with autosomal dominant polycystic kidney disease (ADPKD). She has generally remained well, and you have been treating her for hypertension. Over the past 2 years, she has had a progressive decline in her renal function. She comes to clinic with a calculated glomerular filtration rate of 18 ml/min. You reinitiate discussion about options for renal replacement therapy, and she expresses an interest in pursuing a live related transplant and hopefully avoiding dialysis. Mrs. Matzinger has not had any other major medical illnesses aside from the ADPKD. Specifically, there is no history of malignancy or chronic infection. There has been no documented cardiovascular disease. She has not had any previous blood transfusions.