Many patients with end-stage renal kidney disease are turning to live donor kidney transplantation to improve survival and quality of life because of the shortage of organs available from the deceased donor pool. “Although many healthy adults are eager and willing to accept the risk of donor nephrectomy, the surgical removal of a kidney, to help their loved ones, the responsibility lies within the medical community to quantify these risks and to make this information available to those considering donation,” the authors write.
Dorry L. Segev and colleagues examined the outcomes of 80,347 live kidney donors in the United States between 1994 and 2009, who were drawn from a mandated national registry. A matched group was drawn from 9,364 participants of the third National Health and Nutrition Examination Survey.
During the study period, there were 25 deaths within 90 days of live kidney donation, with the risk of death being 3.1 per 10,000 donors, compared to a rate of death for the matched group of 0.4 per 10,000 persons. By one year following nephrectomy, risk of death in the matched group was similar to the live donor group, likely representing deaths attributable to co-existing illnesses rather than death because of the surgery. The researchers found that long-term mortality was similar or lower for live kidney donors than for the matched group throughout the twelve-year period of follow-up.
“Surgical mortality did not change during the 15-year period, despite differences in surgical practice and donor selection. Men had a statistically significantly higher surgical mortality than women did, as did black individuals versus white and Hispanic individuals,” the authors write. Donors with hypertension also had a statistically significantly higher surgical mortality than did donors without hypertension.
“Regardless of what physiologic changes might occur in a healthy adult after kidney donation, our findings of similar long-term survival between donors and healthy comparison patients suggest that these physiologic changes do not result in premature death,” the authors conclude.
MEDICA.de; Source: American Medical Association (AMA)