Wednesday, March 10, 2010

Kidney donation doesn’t shorten donor’s life

WASHINGTON - Donating a kidney does not appear to significantly increase long-term risk of death, says a new research.

An examination of results for live kidney donors in the U.S. over a 15-year period showed they had similar long-term survival rates as their healthy counterparts who had not donated a kidney.

The study has appeared in the March 10 issue of JAMA.

The authors write: “Although many healthy adults are eager and willing to accept the risk of donor nephrectomy [surgical removal of a kidney] to help their loved ones, the responsibility lies within the medical community to quantify these risks as best as possible and to make this information available to those considering donation.”

Dorry L. Segev of the Johns Hopkins University School of Medicine, Baltimore, and colleagues analysed the outcomes of live kidney donors (80,347) in the US between April 1, 1994, and March 31, 2009, who were drawn from a mandated national registry. Median follow-up was 6.3 years. A matched group was drawn from 9,364 participants of the third National Health and Nutrition Examination Survey (NHANES III).

During the study period, there were 25 deaths within 90 days of live kidney donation, with the risk of death being 3.1 per 10,000 donors, compared to a rate of death for the NHANES III matched group of 0.4 per 10,000 persons. By 1 year followingnephrectomy , risk of death in the matched group was similar to the live donor group, likely representing deaths attributable to comorbidity (co-existing illnesses) rather than death because of the surgery. The scientists discovered that long-term mortality was similar or lower for livekidney donors than for the matched NHANES III group throughout the 12-year period of follow-up (5-year follow-up, 0.4 percent vs. 0.9 percent; 12-year follow-up, 1.5 percent vs. 2.9 percent, respectively).

The authors say: “Surgical mortality did not change during the 15-year period, despite differences in surgical practice and donor selection. Men had a statistically significantly higher surgical mortality than women did, as did black individuals vs. white and Hispanic individuals.” Donors with hypertension also had a statistically significantly higher surgical mortality than did donors without hypertension.

The authors conclude by saying: “Regardless of what physiologic changes might occur in a healthy adult after kidney donation, our findings of similar long-term survival between donors and healthy comparison patients suggest that these physiologic changes do not result in premature death. Although additional studies are clearly needed to better understand the physiologic changes afterkidney donation, the current practice of live kidney donation should continue to be considered a reasonable and safe modality for addressing the profound shortage in deceased donor organs.” (ANI)

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