Abstract

BackgroundProspective studies combining physical functioning (PF), physical activity (PA), and body composition (BC) after living donor transplantation/donation are scarce. We aimed to study differences in these parameters between kidney transplant recipients and their living donors by examining changes in these parameters in the first post-operative year in both groups.MethodsTwenty-two kidney transplant recipients and 22 healthy kidney donors were included in this prospective longitudinal study with a follow-up until twelve months. PF was assessed by handgrip strength (HGS), and by the physical domains of health-related quality of life (HRQOL) using the Short Form-36 questionnaire [PF (SF-36 PF) and physical component summary (PCS) score]. BC was measured by the Body Composition Monitor©, and PA was measured by the SenseWear™ pro3.ResultsAt baseline, recipients had significantly lower HGS (after adjustment for sex and body weight), SF-36 PF, PCS, and PA, as compared with their donors. In recipients HGS significantly increased in the first year after transplantation, but PA did not change in the first six months after transplantation. Furthermore, no significant increase in lean tissue mass was observed. For healthy donors no significant changes in these parameters were observed, with exception of SF-36 PF, which declined in the first three months after donation, but equaled baseline values after twelve months.ConclusionRecipients showed impressive improvements in PF and the physical domains of HRQOL in the first year after transplantation, reaching levels of healthy kidney donors already three to six months after transplantation. On the contrary, living kidney donation did not show any deterioration of the investigated parameters, supporting little impact for well-screened donors, while there is high benefit for transplant recipients.

Highlights

  • Prospective studies combining physical functioning (PF), physical activity (PA), and body composition (BC) after living donor transplantation/donation are scarce

  • One patient was excluded from the study due to intercurrent disease before Kidney transplantation (KTx) (Fig. 1)

  • Immunosuppressive protocol The main features of our center immunosuppressive protocol were: all patients received from time of transplant tacrolimus (TAC) and mycophenolate mofetil (MMF)

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Summary

Introduction

Prospective studies combining physical functioning (PF), physical activity (PA), and body composition (BC) after living donor transplantation/donation are scarce. Kidney transplantation (KTx) is the treatment of choice in end-stage renal disease (ESRD) patients, due to increased patient survival [1, 2], and better health-related quality of life (HRQOL) [3, 4]. Recurrent events such as graft failure and cardiovascular events affect long-term survival [2]. Decreased physical functioning (PF) and Studies combining different parameters related to the physical health domains are scarce. Literature describing outcomes reflecting domains of PF and PA in living kidney donors are scarce as well [16], despite the fact that in healthy donors these domains play an important role in the performance of activities of daily living and concomitant experienced HRQOL

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