Long-term follow-up of living kidney donors – a single center experience

Česká verzia

Authors: Michaela Matysková Kubišová ^1,2; Jaroslav Pacovský ^2,3; Pavel Navrátil jr. ^2,3; Roman Šafránek ^1,2; Pavel Navrátil ^2,3; Igor Guňka ^2,4 ; Sylvie Dusilová Sulková ^1,2
Authors place of work: Nefrologická klinika Fakultní nemocnice Hradec Králové a LF UK ¹; Mezioborové transplantační centrum Fakultní nemocnice Hradec Králové a LF UK ²; Urologická klinika Fakultní nemocnice Hradec Králové a LF UK ³; Chirurgická klinika Fakultní nemocnice Hradec Králové a LF UK ⁴
Published in the journal: Ces Urol 2023; 27(2): 101-108
Category: Original article

Summary

Aim: The main condition for kidney transplants from a living donor is to ensure the donor‘s safety and exclude donation under duress. The aim of our work is to try to describe the risks arising from donation in the context of the current perspective, data from large sets of donors and control groups and describe our own results.

Patients and methods: 56 pairs were enrolled in the retrospective study. The results of the donor were mainly monitored – serum creatinine values, the occurrence of arterial hypertension or diabetes after donation, the effect of smoking on the further fate of the donor and eventual cause of donor death. In the recipient, serum creatinine values and possibly the cause of graft failure.

Results: In our group of donors we register 40 females (71%) and 16 males (29%). The median creatinine level at 5 years after donation is 93 umol /l. None of the living kidney donors developed terminal renal failure during the study period. Pharmacologically compensated arterial hypertension occurred in 29% of donors prior to kidney donation and in the monitored period after transplanation the number of donors with proven arterial hypertension increased to 50%. 43 donors (77%) were non – smokers before surgery and 13 donors (23%) smoked. In our group, the association with smoking history and function of the native kidney was not proven (median creatinine at 5 years after donation in non – smokers 94.5 umol/l, in smokers 82 umol /l). In the study period, 18 graft failures were confirmed, with a median graft function duration of 65 months and a median level of 5 – year creatinine in recipients of 121 umol/l. In seven cases (13% of recipients), the recipient with a functional graft died from another serious comorbidity.

Conclusion: Kidney transplantation from a living donor is a highly effective method of treating renal failure, which has a better success rate compared to transplantation from a deceased donor. A potential living kidney donor must be carefully investigated and given detailed information on the potential risks arising from kidney donation.

Keywords:

long-term results – kidney transplantation – living donors.

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