What is your approach to a living kidney donor evaluation for a patient with normal kidney function who wishes to donate to their monozygotic twin who has ESKD due to an autoimmune disorder?

This really depends on whether there is a genetic component to the autoimmune disorder and whether there is a family history of autoimmune diseases in other members. Depending on the nature of the disease I might get some screening serologies and if positive consider consultation with Rheumatology. ...