Living Donors Online Message Board
Living Donation Discussion and News => Living Donation in the News => Topic started by: Clark on August 29, 2022, 11:09:20 AM
-
https://academic.oup.com/bjs/article/109/8/671/6591555 (https://academic.oup.com/bjs/article/109/8/671/6591555)
Risks for donors associated with living kidney donation: meta-analysis
Maria Irene Bellini, Mikhail Nozdrin, Liset Pengel, Simon Knight, Vassilios Papalois Author Notes
British Journal of Surgery, Volume 109, Issue 8, August 2022, Pages 671–678, https://doi.org/10.1093/bjs/znac114 (https://doi.org/10.1093/bjs/znac114)
Published: 25 May 2022
Abstract
Background
Living kidney donation risk is likely to differ according to donor’s demographics. We aimed to analyse the effects of age, sex, body mass index (BMI) and ethnicity.
Methods
A systematic review and meta-analysis was undertaken of the effects of preoperative patient characteristics on donor kidney function outcomes, surgical complications, and hypertension.
Results
5129 studies were identified, of which 31 met the inclusion criteria, mainly from the USA and Europe. The estimated glomerular filtration rate (eGFR) in donors aged over 60 years was a mean of 9.54 ml per min per 1.73 m2 lower than that of younger donors (P < 0.001). Female donors had higher relative short- and long-term survival. BMI of over 30 kg/m2 was found to significantly lower the donor’s eGFR 1 year after donation: the eGFR of obese donors was lower than that of non-obese patients by a mean of −2.70 (95 per cent c.i. −3.24 to −2.15) ml per min per 1.73 m2 (P < 0.001). Obesity was also associated with higher blood pressure both before and 1 year after donation, and a higher level of proteinuria, but had no impact on operative complications. In the long term, African donors were more likely to develop end-stage renal disease than Caucasians.
Conclusion
Obesity and male sex were associated with inferior outcomes. Older donors (aged over 60 years) have a larger eGFR decline than younger donors, and African donors have a higher incidence of ESRD than Caucasians.