Five-year follow-up after live donor nephrectomy - cross-sectional and longitudinal analysis of a prospective cohort within the era of extended donor eligibility criteria

Abstract

To establish the outcome of live kidney donors 5 years after donation, we investigated the risk for progressive renal function decline and quality of life (QoL). Data on estimated glomerular filtration rate (eGFR), creatinine, hypertension, QoL and survival were assessed in a prospective cohort of 190 donors, who donated between 2008 and 2010. Data were available for >90%. The mean age predonation was 52.8 ± 11.5 years, 30 donors having pre-existent hypertension. The mean follow-up was 5.1 ± 0.9 years. Eight donors had died due to non-donation-related causes. After 5 years, the mean eGFR was 60.2 (95% CI 58.7-62.7) ml/min/1.73 m , with a median serum creatinine of 105.1 (95% CI 102.5-107.8) μmol/l. eGFR decreased to 33.6% and was longitudinally lower among men than women and declining with age (P < 0.001), without any association on QoL. Donors with pre-existent and new-onset hypertension demonstrated no progressive decline of renal function overtime compared to nonhypertensives. No donors were found with proteinuria, microalbuminuria or at risk for end-stage renal disease. After an initial decline postdonation, renal function remained unchanged overtime. Men and ageing seem to affect renal function overtime, while decreased renal function did not affect QoL. These data support further stimulation of living kidney donation programmes as seen from the perspective of donor safety.

Living-donor transplantation leads to a major improvement in physical functioning: an observational study on the impact on potential donors and their recipients

“…Nevertheless, scores still remained higher than scores of the general population [34], and equaled baseline values after twelve months. These findings are in line with recent studies of Janki et al [41, 42], which support our findings that there are no negative short-term consequences for donors with regard to the physical domains of HRQOL.…”

Gender disparity in health-related quality of life and fatigue after living renal donation

“…Mjoen et al revealed women aged > 50 years with a BMI > 25 kg/m 2 as being at high risk for decreased renal function [7]. In a most recent study, GFR decreased about 33.6% and was longitudinally lower among men than women, without any association to HRQoL [22].…”

Psychosocial consequences of living kidney donation: a prospective multicentre study on health-related quality of life, donor–recipient relationships and regret

“…Previous research has mostly used generic HRQoL instruments that do not capture specific relevant donation-related domains [10,11]. The donor's perception on donation consequences for themselves, the recipient and their relationship before and after transplantation has mostly been described in retrospective or qualitative studies [12][13][14][15][16].…”