Date: Sunday, June 2, 2019
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Herbal supplement use in the evaluation phase of live kidney donors (LKD) poses challenges to providers. No formal management guidelines exist. Herbal supplements can create potential risks for interactions with pain medications/anesthesia, as well as possible increased risks for nephrotoxicity, bleeding, infection, and masking of hypertension/hyperglycemia in LKDs. We sought to describe herbal supplement use in LKDs at a high volume transplant center.
*Methods: Single-center retrospective review of LKDs who donated between Sept 30, 2016-Sept 30, 2018. Type and number of supplements reported at initial evaluation and pre-operative visits were reviewed. Herbal supplement use was defined as orally administered herbal or complementary nutritional products (including botanicals, microbial additives, and amino acids), excluding micronutrients(vitamins/minerals), foods/drinks.
*Results: One hundred and fifty-seven LKDs met inclusion criteria, and mean (SD) age was 45 ±11 yrs. At the first evaluation visit: 21 LKDs (13%) reported herbal supplement use, while use was not recorded for 76 LKDs (48%). At the pre-operative visit: 24 LKDs (15%) reported herbal supplement use, 63% of which were first identified at this visit. Mean (SD) time between pre-operative visit and donation was 9 ±5 days. Characteristics of LKDs that reported herbal supplement use vs none is described in Table 1. The most commonly reported herbal supplements at both visits were 1) omega-3-fatty acids (may impact bleeding risk) 2) glucosamine/chondroitin 3) probiotics (may impact infection risk). Of LKDs reporting herbal supplement use, 41% were taking more than one, and each LKD were at least 40 yrs old.
|Characteristic||No herbal supplement (n=120)||Herbal supplement at any time (n=37)||p-value|
|Age > 40 yrs (%)||76(63)||28 (76)||0.23|
|Male (%)||47 (39)||15 (41)||1|
|Reported ethnicity, white (%)||101 (84)||30 (81)||0.85|
|Reported ethnicity, non-white (%)||19 (16)||7 (19)||0.85|
|Reported formal education beyond high school(%)||89 (74)||29 (78)||0.76|
*Conclusions: 1) LKDs that reported taking multiple herbal supplements were older. 2) No significant differences were identified in LKD herbal supplement use by gender, ethnicity, or education status 3) A majority of herbal supplements identified at the face to face pre-operative visit with the transplant pharmacist were not previously identified/recorded by other providers during the initial face to face evaluation. Research is ongoing regarding LKDs patterns of reporting herbal supplement use to providers, supplement risks and potential impacts on evaluation/donation related outcomes.
To cite this abstract in AMA style:Persun N, Johnson D, Leonberg-Yoo A, Bahrainwala J, Reese PP, Collins DM, Houston M, Naji A, Trofe-Clark J. Two-Year, Single Center, Retrospective Review of Herbal Supplement Use in Living Kidney Donors [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/two-year-single-center-retrospective-review-of-herbal-supplement-use-in-living-kidney-donors/. Accessed October 25, 2020.
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