In Iran, the unrelated living kidney donors (LKDs) are financially reimbursed by the government as well as the transplant recipients, a practice legal in the country. We aimed to assess the health status and quality of life of paid unrelated versus related LKDs post-donation at our transplant center in Iran.

We invited all LKDs (n=580) who underwent donor nephrectomy at our center from 2004 to 2010 to participate in a health survey and examination. Participants underwent a complete physical examination, quality of life assessment (using SF-36 questionnaire) and laboratory work-up, including complete blood count, renal function panel, and a 24 hour urine study.

One hundred forty-four of all invited LKDs (25%) [92 {39%} related, 52 {15%} unrelated] consented to participate. On follow-up, the paid unrelated LKDs as compared with related LKDs were younger (34.2±7.2 vs. 40.7±9.7 years, p<0.001), had shorter time since donation (2.9±1.6 vs. 3.8±2 years, p<0.004), had higher e-GFR (72.6±22 vs. 63.8±15.3 mL/min/1.73 m2, p=0.006), and had higher percentage of patients with microalbuminuria (35% vs. 0%, p<0.001). Additionally, social functioning and general health perception scores among paid unrelated LKDs were significantly lower (p=0.02 and p<0.001, respectively) compared with related LKDs. Other SF-36 scores, although lower in paid unrelated LKDs, did not reach statistical significance. There were no differences between the two groups in terms of mean arterial pressure, hemoglobin, and uric acid levels.

Iranian paid unrelated LKDs as compared with related LKDs may be at a higher risk of developing chronic kidney disease due to early onset microalbuminuria, and have lower quality of life.

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