The living, related kidney donor: a follow-up study.
Thirty-eight children received 41 living-donor kidney transplants in an 11-year period; 73% of the grafts are functioning well. The parents of the recipients were the usual donors (60% of the donors were mothers and 25% of the donors were fathers); however, there were five donations from siblings and one donation from a donor who was related emotionally to the recipient. The most frequent perioperative complications were respiratory but these were not serious and did not cause any long-term sequelae. The principal long-term complications that related to--or were perceived by the donor as being related to--the procedure were incisional pain (20% of donors) and depression (25% of donors). These were not related to the success or otherwise of the transplantation. At follow-up, five (12%) donors had diastolic blood pressure levels of greater than 90 mmHg or were receiving antihypertensive therapy; this prevalence is similar to that which is found in the community. Two donors had urinary protein excretion rates of greater than 200 mg/24 h (210 mg/24 h and 350 mg/24 h, respectively). Creatinine clearance rates fell by 15% in women and by 5% in men. Serum creatinine levels had risen by 40% in men and by 35% in women after the nephrectomy; these levels had changed little at follow-up. All donors said that they would have proceeded with the donation even with fore-knowledge of what they would experience during and after the donation. Living-donor renal transplantation is a procedure with very low but definite operative risks which nevertheless provides a means for the early effective replacement of renal function in children with growth potential. The donors are enabled to make a major contribution to the life and well-being of the child, and they regard the perioperative complications as minimal. There do not appear to be any serious long-term complications of renal donation.
Liounis
B
B
Department of Nephrology, Royal Alexandra Hospital for Children, Camperdown, NSW.
Roy
L P
LP
Thompson
J F
JF
May
J
J
Sheil
A G
AG
D000293:Adolescent; D000328:Adult; D002648:Child; D003404:Creatinine / Q000378:metabolism; D005190:Family; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects*; D011507:Proteinuria / Q000209:etiology; D018570:Risk Assessment; D035781:Siblings; D014019:Tissue Donors / Q000523:psychology*; D009927:Tissue and Organ Procurement
D003404:Creatinine