Impact of Living Kidney Donation on Long-Term Renal and Patient Survival: An Evolving Paradigm

Abstract During the last decades, there have been several studies reporting the outcome after living kidney donation. These studies have not shown any increase in mortality or end-stage renal disease. This is reassuring for potential donors. However, in these studies, kidney donors have been compared with unselected general population controls. In recent studies, kidney donors have been compared with selected healthy controls designed to simulate the donor selection process and improve quantification of the attributable impacts of donation. Also, recent studies describe donor cohorts with a longer follow-up. One of these studies found increased mortality risk, and several studies have found increased risk of end-stage renal disease occurring several years after donation. These findings have consequences for how we evaluate and select living donors. Future studies on mortality and end-stage renal disease in donors should focus on large donor cohorts with a long follow-up and appropriate healthy control groups. Cross sectional studies performed months or years after donation should focus on comparisons with controls who were healthy at the time of the donor`s evaluation. Although recent studies have indicated attributable risks compared with healthy controls, absolute event rates of end-stage renal disease and/or mortality appear fairly low. Although these studies have modified our assessment of donor risk, we still promote living kidney donation.
Source: Current Transplantation Reports - Category: Transplant Surgery Source Type: research