A retrospective study to assess the evaluation of living related kidney donors and their outcomes following nephrectomy at Kenyatta National Hospital

Abstract

BackgroundKidney transplantation is the renal replacement therapy of choice for end stage renal disease. To ensure safety regular audit of the donation process is necessary. The aim of this study was to assess the evaluation of potential living related kidney donors and document their outcomes following nephrectomy.MethodsThis was a retrospective descriptive study involving all living related kidney donors seen at Kenyatta National Hospital (KNH) renal unit from 2010 to 2014.Upon approval by KNH/ERC, the records of all kidney donors were retrieved. Demographic characteristics, number of potential and actual donors, their clinical, laboratory and radiological data as well as documented complications and deaths were recorded. SPSS version 17(Chicago, Ilinois) was used for data entry and analysis. Chi square test and Mann Whitney U test were used as tests of association for categorical and continuous data respectively, with P value set at <0.05.ResultsMedian age of the donors was 34 years (IQR 31–39). First-degree relatives were majority(84.5%). Renal function assessment was done using mean glomerular filtration rate (GFR) from the radionuclide scan (DTPA) and serum creatinine levels. The donors had a mean GFR of 99.2 ± SD 6.6. All the haematological and biochemical tests were within normal. Majority(42.9%) were HLA compatible, but data on HLA typing was missing for 22% of the patients records. On CT angiogram, single renal artery and single renal vein were found in 94 and 88% respectively. Immediate complications included excessive bleeding(2%) and breach of other cavities (4%). Paralytic ileus (32%) and atelectasis (27%) were the most common early postoperative complications. There was no mortality.ConclusionOur study reports no fatality but significant post-operative complications. These are significant findings that may be used to review and improve care and to educate potential kidney donors on the safety of this procedure in our centre, in a bid to widen the pool of potential living kidney donors.

A Single-Center Study on the Clinical Profiles and Ultrasonographic Assessments of Living Kidney Donors in the Marathwada Region of Maharashtra

“…The majority of donors being parents or spouses suggests a familial inclination toward organ donation. This aligns with other studies emphasizing the prevalence of first-degree relatives as donors [13][14][15]. Our study suggests that encouraging awareness among male spouses could further enhance organ donation rates, reflecting the need for targeted interventions.…”

“…Additionally, the study observes a higher proportion of female donors, with a male-to-female ratio of 1:3.4. This gender distribution trend aligns with previous studies in Kerala [12] and Maharashtra [13], but is contrary to findings from Kenya [14], where the majority of the donors are males (61%). Our findings emphasize the need for increased awareness among male donors about organ donation.…”

Renal vascular disparities among kidney donors presented at renal transplant unit- A single centre study

“…Because of this, CTA is crucial in selecting the best donor kidney based on the vasculature. According to earlier research, CTA can accurately identify donor vessels 95% to 100% of the time (12). All CTA results in our investigation were in agreement with the results of the operations on the harvested kidneys.…”

“…It is technically simpler to transplant kidneys with one renal artery than kidneys with several renal arteries. Furthermore, compared to kidney transplantation involving transplantation of kidneys with more than one renal artery, the postoperative rates of complication and kidney loss are lower when transplanting kidneys with just one renal artery (11,12). For a successful graft nephrectomy, the surgeon must have precise preoperative knowledge of the donor's renal vasculature in order to lower the risk of vascular injury and decrease the time of ischemia.…”

Kidney Transplantation in Nigeria: A Single Centre’s Early Surgical Experience and Outcomes

“…In another study by Van der Merwe & Heyns among 50 South Africans, the prevalence of complications was 10%, out of which renal vein reconstruction was 4%, and infection, urethral injury and acute gastritis were all 2% [34]. Meanwhile a 4-year retrospective study in Kenyatta National Hospital reported the prevalence of donor complication to be 7.14%, the distribution being pleural breach (3.57%), hemorrhage (2.38%) and peritoneal breach (1.19%) [35]. Factors significantly associated with increased risk of donor complications following nephrectomy are African-American race, hematologic and psychiatric conditions, older age, obesity, and pre-donation hypertension [33,36,37].…”