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Author Topic: Left-Sided Living Kidney Donation Leads to Transiently Reduced Adrenocortical Re  (Read 1627 times)

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Offline Clark

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http://onlinelibrary.wiley.com/doi/10.1111/ajt.14184/abstract?campaign=wolacceptedarticle

Left-Sided Living Kidney Donation Leads to Transiently Reduced Adrenocortical Responsiveness
Authors
      F. Burn, et al.,
      First published: 1 February 2017
      DOI: 10.1111/ajt.14184
Abstract
Living kidney donation is safe and established, but can lead to long-term complications such as chronic fatigue. Since the adrenal vein is usually transected during left-sided donor nephrectomy—which is not necessary on the right—we hypothesized that venous congestion might lead to an impairment of adrenal function, offering a possible explanation. In this prospective open label, monocentric cohort study, adrenal function was compared in left- and right-sided living kidney donors. The primary endpoint was plasma cortisol response to low-dose adrenocorticotropic hormone (ACTH) stimulation. Secondary endpoints included plasma renin and ACTH concentration as well as adrenal volume in response to donor nephrectomy. A total of 30 healthy donors—20 left- and 10 right-sided donations—were included. On postoperative day 1, response to low-dose ACTH stimulation was intact, but significantly lower after left-sided donor nephrectomy. After 28 days, adrenal responsiveness to ACTH stimulation did not differ any longer. Magnetic resonance imaging volumetry showed no significant adrenal volume change over 4 weeks, neither after left- nor after right-sided nephrectomy. In conclusion, left-sided living kidney donation entails a transiently reduced adrenocortical responsiveness, which returns to baseline after 28 days.
Unrelated directed kidney donor in 2003, 500+ time blood & platelet donor and counting!
Rep to the OPTN/UNOS Boards of Directors & Executive, Kidney Transplantation, & Ad Hoc Public Solicitation of Organ Donors Committees 2005-2011

 

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