Long Term Renal and Patient Risks for Living Kidney Donors
Division of Nephrology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Meeting: 2018 American Transplant Congress
Abstract number: 333
Keywords: Donation, Kidney transplantation, Morbidity, Mortality
Session Information
Session Name: Concurrent Session: Kidney Living Donor: Long Term Outcomes
Session Type: Concurrent Session
Date: Monday, June 4, 2018
Session Time: 4:30pm-6:00pm
Presentation Time: 5:06pm-5:18pm
Location: Room 6A
Purpose:
Recent studies have issued that living kidney donor (LKD) might be exposed to higher risk for end-stage renal disease (ESRD) and death, compared with healthy control (HC), although there is a racial difference.
Methods:
We collected data of 1,294 LKDs who underwent nephrectomy from 1986 to 2016. We obtained renal complications including ESRD and mortality data by reviewing medical record, ESRD registry supported by the Korean Society of Nephrology, and Statistics Korea using a unique identifier. As a potentially eligible donors, we included a total of 42,403 HCs who underwent health examination from 1995 to 2006. Before comparisons, we excluded HCs with hypertension, diabetes, malignancies, lower eGFR less than 80 ml/min/1.73m2, and advanced age older than 70 years. Mortality rate of both LKDs and HCs was compared with general population using standardized mortality ratio (SMR). Finally we evaluated impact of LKD on mortality using cox regression analysis.
Results:
After exclusion, a total of 1,056 LKDs and 18,438 HCs were included. Median follow-up was 8.9 (IQR 4.3-15.2) years in LKDs and 14.8 (IQR 12.5-17.8) years in HCs, respectively. There were only minimal differences between LKDs and HCs in age, systolic blood pressure, body mass index and serum albumin levels. During follow-up, 210 (21.4%) donors remained with their eGFR < 60 ml/min/1.73m2, but only 2 donors progressed to ESRD. Among LKDs, 41 (3.2%) were dead. Causes of death were 13 malignancies, 2 cardiovascular diseases, 3 renal diseases, 7 trauma, and etc. Both HCs (SMR 0.10, 95% CI 0.09-0.10) and LKDs (SMR 0.15, 95% CI 0.11-0.21) revealed excellent mortality ratio compared with age, sex matched general population. In the Kaplan-Meier analysis, LKDs showed similar ESRD progression (log rank P = 0.239) and all-cause mortality (log rank P = 0.636), compared with matched HCs. Even after multivariate survival analysis, donor nephrectomy did not elevate renal and patient death.
Conclusion:
In this study, we demonstrated that kidney donation did not increase long-term risk for ESRD and death when compared with matched HCs who may potentially eligible for donation.
CITATION INFORMATION: Kim Y., Yu M., Kim Y., Lee H. Long Term Renal and Patient Risks for Living Kidney Donors Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kim Y, Yu M, Kim Y, Lee H. Long Term Renal and Patient Risks for Living Kidney Donors [abstract]. https://atcmeetingabstracts.com/abstract/long-term-renal-and-patient-risks-for-living-kidney-donors/. Accessed May 16, 2025.« Back to 2018 American Transplant Congress