*Purpose: Transplantation and optional living donation is the therapy of choice in end-stage renal disease. Due to the increase of living kidney donoration (LD), the safety and voluntary of LD must have the highest priority. So far, there is no prospective and valid information about pre- and postoperative risks as well as long-term consequences of LD in the predominant Caucasian and female population. Special attention should be payed to psychosocial consequences of LD since data on gender specific quality of life and fatigue are sparse.

*Methods: In a prospective multicentre cohort study (SoLKiD – Safety of Living Kidney Donors) we examined the clinical and psychosocial outcome of 335 living kidney donors over 12 months, before (T0) and 1,6,12 months (T1-T3) after LD. The primary targets were renal function (eGFR) and quality of life (LQ). Other influencing factors were blood pressure (MAD), age, gender and the development of Fatigue.We used validated tests: SF-36 PCS, MCS-Health survey and MFI.

*Results: In our study cohort we evaluated 60% women (f) and 40% men (m). Mean age: 53,03±9,34 (f) / 51,10±10,13 (m) years. GFR at T0 was at 93.35 ml/min/1.73m² (m) and 92.8 ml/min/1.73m² (f). At T3 about 32% decrease in GFR (f:59.18 ml/min/1.73m²; m:61.24 ml/min/1.73m²).The largest decrease occurred at T1 immediately after LD (GFRT0-T3:R=0,334,p<0,001). Significant gender differences in MAD at T3 (f:95,44±11,31 vs m:99,47±9,86;p=0,003) were detected. De novo hypertension developed in 2.5% (f) vs 1.5% (m) at T3 (n.s.). A decrease (T0 to T3) of physical (PCS) and mental (MCS) LQ was observed (PCS:58.15 to 56.89 (m);58.19 to 57.23 (f);m vs f:T0:p=0,39,T3:p=0,63);MCS:56.6 to 56.2 (m);54.49 to 54.26 (f);m vs f:T0:p=0,003,T3:p=0,025). The general fatigue parameter MFI showed a slight increase (T0 toT3:m:7 to 8 and f:6.83 to 8, m vs f:T3:p=0,61).There is no significant age-related prevalence compared to the German general population.The study cohort showed consistently lower values. Higher general fatigue scores correlate significantly with previous fatigue values (R:T0 to T3:0,23;p=0,013). There was no gender related difference in physical LQ or Fatigue, but in mental LQ.

*Conclusions: Our study showed reduced postdonation renal function, but no eGFR <30ml/min/1,73m² and no gender dependent differences in long-term kidney function (p=0,161). Blood pressure showed an increased prevalence (f:2,5% vs m:1,5%) of de novo hypertension (n.s.) and significant gender differences in MAD after 12 months. In our cohort, an overall gender independent decreasing trend in LQ (T0-T3) was observed (n.s.). Particularly female donors do not experience Fatigue or reduced physical LQ. Psychological aftercare should be offered to Donors with risk of Fatigue and reduced LQ.

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