TY - JOUR
T1 - Risks of living kidney donation
T2 - Current state of knowledge on outcomes important to donors
AU - Lentine, Krista L.
AU - Lam, Ngan N.
AU - Segev, Dorry L.
N1 - Funding Information:
Heather Hunt, JD, and Alvin Thomas, MSPH, collaborated in preparing the original infographic for this article and grant permission for its use. Ms. Hunt is president of LIVE ON Organ Donation, Inc., a nonprofit organization that raises money to support living organ donors’ nonmedical expenses, and is vice chair of the Organ Procurement and Transplantation Network (OPTN)/United Network for Organ Sharing (UNOS) Living Donor Committee. Mr. Thomas is a student in the Department of Epidemiology at the University of North Carolina at Chapel Hill.
Publisher Copyright:
© 2019 by the American Society of Nephrology.
PY - 2019/4/5
Y1 - 2019/4/5
N2 - In the past decade, there have been increasing efforts to better define and quantify the short- and long-termrisks of living kidney donation.Recent studies have expanded upon the previous literature by focusing on outcomes that are important to potential and previous donors, applying unique databases and/or registries to follow large cohorts of donors for longer periods of time, andcomparing outcomeswithhealthynondonor controls toestimate attributable risks of donation. Leading outcomes important to living kidney donors include kidney health, surgical risks, and psychosocial effects of donation. Recent data support that living donors may experience a small increased risk of severeCKDandESKDcompared withhealthynondonors. Formostdonors, the15-year riskof kidney failure is<1%, but for certain populations, such as young, black men, this risk may be higher. New risk prediction tools that combine the effects of demographic and health factors, and innovations in genetic risk markers are improving kidney risk stratification.Minor perioperative complications occur in 10%-20%of donor nephrectomy cases, but major complications occur in <3%, and the risk of perioperative death is <0.03%.Generally, living kidney donors have similar or improved psychosocial outcomes, such as quality of life, after donation compared with before donation and comparedwith nondonors.Although the donation process should befinancially neutral, living kidney donorsmay experience out-of-pocket expenses and lostwages thatmay ormay not be completely covered through regional or national reimbursement programs, and may face difficulties arranging subsequent life and health insurance. Living kidney donors should be fully informed of the perioperative and long-term risks before making their decision to donate. Follow-up care allows for preventative care measures to mitigate risk and ongoing surveillance and reporting of donor outcomes to inform prior and future living kidney donors.
AB - In the past decade, there have been increasing efforts to better define and quantify the short- and long-termrisks of living kidney donation.Recent studies have expanded upon the previous literature by focusing on outcomes that are important to potential and previous donors, applying unique databases and/or registries to follow large cohorts of donors for longer periods of time, andcomparing outcomeswithhealthynondonor controls toestimate attributable risks of donation. Leading outcomes important to living kidney donors include kidney health, surgical risks, and psychosocial effects of donation. Recent data support that living donors may experience a small increased risk of severeCKDandESKDcompared withhealthynondonors. Formostdonors, the15-year riskof kidney failure is<1%, but for certain populations, such as young, black men, this risk may be higher. New risk prediction tools that combine the effects of demographic and health factors, and innovations in genetic risk markers are improving kidney risk stratification.Minor perioperative complications occur in 10%-20%of donor nephrectomy cases, but major complications occur in <3%, and the risk of perioperative death is <0.03%.Generally, living kidney donors have similar or improved psychosocial outcomes, such as quality of life, after donation compared with before donation and comparedwith nondonors.Although the donation process should befinancially neutral, living kidney donorsmay experience out-of-pocket expenses and lostwages thatmay ormay not be completely covered through regional or national reimbursement programs, and may face difficulties arranging subsequent life and health insurance. Living kidney donors should be fully informed of the perioperative and long-term risks before making their decision to donate. Follow-up care allows for preventative care measures to mitigate risk and ongoing surveillance and reporting of donor outcomes to inform prior and future living kidney donors.
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U2 - 10.2215/CJN.11220918
DO - 10.2215/CJN.11220918
M3 - Article
C2 - 30858158
AN - SCOPUS:85064493774
SN - 1555-9041
VL - 14
SP - 597
EP - 608
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 4
ER -