Guarding the Health of Kidney Donors

Kidney donor surgical complications have fallen but preexisting health disorders have risen

(RxWiki News) Kidney transplants have added years to the lives of many who've received that vital, donated organ. For donors who are alive, giving a kidney generally poses no major, immediate risks.

A new study has found a decline in the number of several post-surgery complications for kidney donors. But the same study found a comparatively sharp increase in depression, obesity and other previously diagnosed illnesses among those donors.

Given donors' pre-existing medical conditions, all living donors should be more closely monitored following their surgery, the researchers wrote.

"Follow up regularly with your doctor after donating a kidney."

The study's lead author was Jesse Schold, PhD, MEd, MStat, director of Outcomes Research and Medical Informatics, Kidney and Kidney/Pancreas Transplantation at Cleveland Clinic's Glickman Urological and Kidney Institute.

Dr. Schold and his team of investigators studied the medical records of 69,000 people in the United States who donated kidneys between 1998 and 2010. That group represented roughly 90 percent of all kidney donations nationwide at the time.

These researchers found that digestive or respiratory problems, infections, accidental surgical cuts, excessive bleeding, heart ailments and urinary problems that were related to operations to get donors' kidneys fell from 10.1 percent to 7.6 percent during the study period.

The study also concluded that the average amount of time that donors remained in the hospital after surgery dropped from 3.7 days to 2.5 days during those 12 years that were examined.

Those rates of hospitalization and post-surgical complications for donors were similar to the complications and hospital stays among people undergoing such relatively low-risk operations as appendix or gall bladder removal, the researchers wrote.

Nevertheless, the researchers wrote, the number of donors who, before donor surgery, had been diagnosed with high blood pressure, depression, ongoing lung problems or an underactive thyroid more than tripled during the study period. Overall, those individuals represented about 3.5 percent of all donors.

"Although the principal findings on risks for living donors are reassuring, continued vigilance regarding their safety is critical," the researchers wrote. "Particularly given evidence that screening criteria for living donation vary among centers and may have become [less strict] in recent years, monitoring short- and long-term health of donors from all sources is important."

This study also showed that male donors were more than twice as likely as women to have post-surgical complications. People with high blood pressure were more than three times as likely as those without high blood pressure to have complications.

Depression was most common among older donors. Obesity was more likely among female and African American donors. High blood pressure was highest among older donors and African American donors. Donors with hypothyroidism were more likely to be female, white, older and also diagnosed with depression.

Roughly 60 percent of the studied donors were women. Almost 68 percent of them were white. On average, the donors were 40 years old.

The donors had been selected from the federal Agency for Healthcare Research and Quality's National Inpatient Sample and the Scientific Registry of Transplant Recipients.

Kidneys are the most commonly transplanted organ in the United States. About a third of those donations come from living donors.

This study was published online September 26 in the Clinical Journal of the American Society of Nephrology (CJASN).

The National Institutes of Health and National Institutes of Mental Health funded the study.

The researchers did not disclose any financial investments or other involvement that would shape study design or outcomes.

Review Date: 
September 26, 2013