Comparison of accepted and unaccepted living kidney donors: one-center experience

Ren Fail. 2018 Nov;40(1):152-159. doi: 10.1080/0886022X.2018.1450758.

Abstract

Background: Kidney transplantation from living donors (LD) has stagnated in many countries. This study aimed to check whether correction of LD selection practice could increase the number of kidney transplantations.

Methods: From January 2003 to December 2012, 241 potential adult LD were evaluated in our hospital. Outcome (mortality and end-stage renal disease-ESRD) of accepted LD (182) was compared with unaccepted (59) donors.

Results: Mortality of LD was comparable with that for the standardized Serbian population (SMR = 1.104; 95% CI (0.730-1.606). Among evaluated potential LD, almost every fourth had been unaccepted, but reasons were modifiable in 42.4% of them. In pre-donation period unaccepted donors were significantly older, measured glomerular filtration rate was lower, with higher 15-year and lifelong projected ESRD risks than accepted donors. Despite this, ten years outcome of both groups LD was similar: none of LD developed ESRD, 9.8% of accepted and 11.8% of unaccepted LD died (p = .803).

Conclusions: During an average of 101 months of follow-up mortality of accepted LD did not differ significantly as compared to the age standardized Serbian population and none of them developed ESRD. In examination of potential LD, the use of accurate and precise methods for kidney function estimation and the evaluation of risk for ESRD and mortality as well as treatment of modifiable contraindications for kidney donation are necessary.

Keywords: Kidney transplantation; donor evaluation; donor risk; living donor; selection criteria.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Donor Selection / methods
  • Donor Selection / standards*
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Kidney Failure, Chronic / mortality
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / surgery*
  • Kidney Transplantation / methods*
  • Kidney Transplantation / statistics & numerical data
  • Living Donors*
  • Male
  • Middle Aged
  • Practice Guidelines as Topic
  • Risk Assessment / methods
  • Risk Assessment / standards
  • Serbia / epidemiology
  • Treatment Outcome
  • Young Adult

Grants and funding

This work was conducted as a part of project No. 175089 funded by the Ministry of Science, Education and Technological Development, Belgrade, Republic of Serbia.