Renal outcome of living kidney donors at Tlemcen University Hospital

Abstract

Renal transplantation from living donors is the most beneficial for recipients in terms of survival and quality of life. However, this option raises many questions, including the risks for the donor. The objective of the study was to investigate the occurrence of complications such as kidney failure or high blood pressure in the short and long term after kidney donation. Descriptive cross-sectional study of 100 living donors who have donated a kidney to their relatives at least one year ago, between 2007 and 2017. The evaluation criteria were the complications of nephrectomy in the short and long term: occurrence of renal failure, high blood pressure or proteinuria. The donors’ mean age was 39.8 years old, 2/3 of donors were women. Donors were parents (34.7%), collateral (50.6%) or spouses (10.7%). Only 3 donors had a laparoscopy. Perioperative and subsequent mortality was null. Five donors have pregnancies after donation without any fetus or maternal complications. The main complaints expressed concerned pain and scarring after-effects. Donor-recipient relationships improved in 86% of cases and remained unchanged in the remaining (14%). After a mean delay post-transplant of 5 years, no donor developed a renal failure, or a proteinuria. Mean GFR was 88,5 ml/min/1,73m 2 , and no donor had lower GFR than 60 ml/min/1.73 m 2 . However, 6 years after surgery, 5.6% of patients developed high blood pressure. The results of our study did not reveal any risk associated with donation in comparison with the general population. However, recent studies have reported a higher risk of chronic renal failure in kidney donors compared to control subjects. Biases were identified in the selection of control groups for these latter studies. Indeed, our study did not include a control group, however, after a medium delay of 5 years, we did not observe donors’ renal complication, probably because our population is predominantly made of young subjects. However, our present work strongly pleads for a rigorous evaluation of potential donors. Transplantation from living donors allows better results in terms of graft survival without exposing the donor to inconsiderate risks, provided that the donors are properly selected.