Post-Donation Medical Research
Because living kidney donation has been practiced for
more
than 40 years, research has been conducted on the long-term effects of
donation on the donor. In general, these studies have shown little
negative impact. However, the volume and rigor of studies is inadequate
relative to the amount of research on cadaveric donation and transplant
recipients and the fact that roughly half of transplant come from
living donors. Also, studies tend to lack statistic rigor, such as
being based on a single transplant center's experience, relying on
self-reported data, or being subject to sampling bias. Additional
rigorous research on the impact of living donation is needed.
Here's a digest of some of the research results that are publicly available:
-
Najarian, et al., 1992. This
study of 57 donors 20
or more years after donation measured renal function, blood pressure,
and proteinuria (an excess of protein in the urine) compared to their
siblings. The donors showed no significant differences in health.
The study also assessed the risk of mortality from
the
donation process by surveying members of the American Society of
Transplant Surgeons. The results yielded a mortality rate estimated to
be 0.03%.
-
Undurraga, A, et al., 1998. A
study of 74 donors
showed adequate renal function when compared to a control group. A
slightly higher incidence of high blood pressure, proteinuria, and
microhematuria (excess blood in the urine) was identified.
-
Fehrman-Ekholm, I., 1997. This
Swedish study
evaluated the life span of living kidney donors. Of 430 people who
donated between 1964 and 1994, 41 died from 18 months to 31 years
following donation. The causes of death included cardiovascular
disease, cancer, injury or accidents, gastrointestinal disease,
alcoholism, and other diseases. None died of kidney disease.
The study also concluded that the survival rates of donors were 29%
higher
than the general population, possibly due to the careful selection of
donors based on their health (i.e., donors tend to be healthier than
the general population.)
-
McCune,
TR, et al., 2004.
This study shares the results of a program by the South-Eastern Organ
Procurement Foundation tracking the experiences of living donors.
Information is collected using questionnaires at the time of donation,
then after three months, six months, and annually thereafter. The study
reported the following findings:
-
Donors relied on employer-provided paid time off
(vacation and sick leave) for recuperation, but but the average donor
also required 12 weeks of unpaid
leave before returning to work.
-
Donors had out-of-pocket expenses for
transportation,
lodging, and childcare.
-
Anti-depressants were prescribed for about 11%
of
donors.
-
About 5% of donors were treated for hypertension.
-
Nearly 38% of donors reported experiencing
complications from the donation, with 7.6% of the complications being
serious enough to require hospitalization or surgery.
-
Ramcharan
and Matas, 2002.
This study updates the findings from the first study above (Najarian,
et al.), looking at health of 773 living donors 20 to 37 years after
donation. Of the group, 84 had died, three of renal failure. Of the
living donors, three had abnormal kidney function and two had undergone
transplantation. The remaining donors had normal kidney function. The
rates of proteinuria and hypertension were comparable to the general
population. The study concludes that most kidney donors have normal
kidney function 20 to 37 years following donation. Some donors do
experience renal dysfunction or failure.
These studies and others like them strongly suggest
there are
few if any health consequences from donating a kidney.
|