Journal List > J Korean Soc Transplant > v.26(1) > 1034365

Lee, Park, Chung, and Choi: Long Term Outcomes for Living Renal Donors

Abstract

Background

Kidney donation is a relatively safe procedure with minimal adverse effects. But some reports have described the development of proteinuria and hypertension in donors after nephrectomy. There have been a number of non-Korean studies which conclude that the procedure is relatively safe and a good quality of life is expected for living donors after kidney transplantation, but not enough of these studies have been published in Korea. We evaluated the physiologic and psychosocial impacts after kidney donation in this study.

Methods

Between April 1988 and April 2010, we performed 201 living donor nephrectomies and obtained information for 88 (43.7%) of the donors. We measured their estimated glomerular filtration rate (GFR), blood pressure, body mass index, hemoglobin and cholesterol level, and assessed the prevalence of hypertension and proteinuria in this group. These donors completed a questionnaire regarding their health status and psychosocial outcomes after donation.

Results

The average time of the donor assessment after nephrectomy was 95.05±85.45 months (range, 6~261). The left kidney was used in 76 patients (86%). There was a total complication rate of 8%, but no serious complications were observed. Proteinuria was found in 9 patients (10%) and hypertension in 11 patients (11%). GFR decreased from 103.65±25.02 mL/min to 76.12±19.90 mL/min (P<0.001) and hemoglobin decreased from 13.91±1.62 g/dL to 13.01±1.72 g/dL (P<0.001). Five patients (6%) developed a post-donation GFR between 40 and 60 mL/min, with 2 patients being observed to have a post-donation GFR below 20 mL/min. In the questionnaire responses, most donors did not report problems affecting routine life or any economic impact. Their donation satisfaction results were very high (92%).

Conclusions

Living kidney donors were observed to result in reduced GFR after nephrectomy. Follow-up visits with living kidney donors is essential in order to monitor risk factors related to the deterioration of their residual kidney function.

Figures and Tables

Table 1
Comparison of health status after kidney donation
jkstn-26-10-i001

Abbrebiations: e-GFR, estimated glomerular filtration rate; BMI, body mass index; BP, blood pressure.

Table 2
Risk factor of reduced GFR for living kidney donor
jkstn-26-10-i002

Abbrebiations: CKD, chronic kidney disease; BMI, body mass index.

References

1. Korean Network for Organ Sharing (KONOS). 2011 KONOS Annual Report [Internet]. 2011. Seoul: KONOS;Available from: http://www.konos.go.kr.
2. Ibrahim HN, Foley R, Tan L, Rogers T, Bailey RF, Guo H, et al. Long-term consequences of kidney donation. N Engl J Med. 2009. 360:459–469.
3. Okamoto M, Akioka K, Nobori S, Ushigome H, Kozaki K, Kaihara S, et al. Short- and long-term donor outcome after kidney donation; analysis of 601 cases over a 35-year period at Japanese single center. Transplantation. 2009. 87:419–423.
4. Textor SC, Taler SJ, Larson TS, Prieto M, Griffin M, Gloor J, et al. Blood pressure evaluation among older living kidney donors. J Am Soc Nephrol. 2003. 14:2159–2167.
5. Isotani S, Fujisawa M, Ichikawa Y, Ishimura T, Matsumoto O, Hamami G, et al. Quality of life of living kidney donors: the short-form 36-item health questionnaire survey. Urology. 2002. 60:588–592.
6. Hwang HS, Kim SY. Safety for expanding living-donor criteria in renal transplantation. J Korean Soc Transplant. 2010. 24:80–86.
7. Kaneku HK, Terasaki PI. Thirty year trend in kidney transplants; UCLA and UNOS Renal Transplant Registry. Clin Transpl. 2006. 1–27.
8. Moon JI, Kim SD, Kim SI, Kim SH, Kim YS, Park K. Long term follow-up of living kidney donors. J Korean Soc Transplant. 1998. 12:229–233.
9. Delmonico F. Council of the Transplantation Society. A report of the Amsterdam forum on the care of the live kidney donor: data and medical guidelines. Transplantation. 2005. 79:6 Suppl. S53–S66.
10. Fehrman-Ekholm I, Elinder CG, Stenbeck M, Tyden G, Groth CG. Kidney donors live longer. Transplantation. 1997. 64:976–978.
11. Garg AX, Muirhead N, Knoll G, Yang RC, Prasad GV, Thiessen-Philbrook H, et al. Proteinuria and reduced kidney function in living kidney donors: A systematic review, meta-analysis, and meta-regression. Kidney Int. 2006. 70:1801–1810.
12. Chang HK, Ju MK, Ahn HJ, Kim HJ, Jeon KO, Kim MS, et al. Long-term change of renal function after donor nephrectomy for kidney transplantation. J Korean Soc Transplant. 2007. 21:75–80.
13. Kakuta T, Suzuki Y, Hida M, Wakabayasi M, Fujisaki T, Kitamura M, et al. Functional evaluation of the remaining kidney in kidney donors by radionuclide dynamic imaging using a graphic method with factor analysis. Nucl Med Commun. 1997. 18:937–942.
14. Boudville N, Prasad GV, Knoll G, Muirhead N, Thiessen-Philbrook H, Yang RC, et al. Meta-analysis: risk for hypertension in living kidney donors. Ann Intern Med. 2006. 145:185–196.
15. Klag MJ, Whelton PK, Randall BL, Neaton JD, Brancati FL, Ford CE, et al. Blood pressure and end-stage renal disease in men. N Engl J Med. 1996. 334:13–18.
16. Textor S, Taler S. Expanding criteria for living kidney donors: what are the limits? Transplant Rev (Orlando). 2008. 22:187–191.
17. Tan L, Tai BC, Wu F, Raman L, Consigliere D, Tiong HY. Impact of kidney disease outcome quality initiative guidelines on the prevalence of chronic kidney disease after living donor nephrectomy. J Urol. 2011. 185:1820–1825.
18. Soneji ND, Vyas J, PApalois VE. Long-term donor outcome after living kidney donation. Exp Clin Transplant. 2008. 6:215–223.
19. Ruiz-Deya G, Cheng S, Palmer E, Thomas R, Slakey D. Open donor, laparoscopic donor and hand assisted laparoscopic donor nephrectomy: a comparison of outcomes. J Urol. 2001. 166:1270–1273.
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