Introduction

Research suggests long-term health of living kidney donors is comparable to the general population. However, there are limited comprehensive studies of morbidity among this population and criteria for living donor candidacy have been shown to be highly variable between US transplant centers. Our aim was to evaluate secular trends of comorbid conditions among living donors in the US.

Methods

We utilized a specialized database administered by AHRQ which contains data for hospitalizations across the US. The data includes all diagnoses and procedure codes for hospitalized patients. We evaluated the presence of comorbid conditions among donors (n=69,117 from 1998-2010) at the time of donor nephrectomy and examined the association of comorbid conditions with procedure-related complications, hospital length of stay and readmissions adjusted for demographic and hospital characteristics and payer status.

Results

The overall proportion of comorbid conditions was relatively small (<5%), however the proportions of a number of conditions markedly increased over the study period (Figure 1). Overall complication rates were 8% and both complication rates and length of stay(LOS) significantly declined over the study period. In multivariable models, presence of hypertension was strongly associated with procedure-related complications (AOR=2.70,1.81-4.02), longer LOS +0.28 days(p=0.006) and greater likelihood of readmission (AHR=1.69, 1.06-2.72). Depression was also significantly associated with LOS (+0.18 days, p=0.005) and greater risk of readmission (AHR=1.77,1.10-2.87). Characteristics of the study population were highly concordant with data based on the SRTR.

Discussion

Although long-term studies provide reassurance regarding the health of living donors, these data suggest continued vigilance of donor outcomes and careful ongoing consideration of donor candidacy are needed.

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