title: Living related donor nephrectomy in transfusion refusing donors.
abstract: Many transplant programs are averse to evaluate potential kidney donors with preferences against accepting human blood products. We examined the donor and graft outcomes between our transfusion-consenting (TC) and transfusion-refusing (TR) live kidney donors to determine whether a functional or survival disadvantage resulted from the disallowance of blood product transfusion during live donor (LD) nephrectomy. From July, 1999 to August, 2005, 82 live donor nephrectomies were performed, eight of who were TR donors (10%). Blood conservation techniques were utilized in TR donors. Demographics, surgical and functional outcomes, admission and discharge hematocrit, and creatinine were compared between TC and TR donors. No donor mortalities occurred. Two TC donors received blood transfusions (2.7%), and each study group experienced a single, <1-year graft loss. Intra-operative blood losses were significantly less in TR donors (298 +/- 412 vs. 121 +/- 91 ml, P < 0.03). No differences were noted between donor demographics, intra-operative events, and graft and patient survival. Successful donor nephrectomy from TR patients has the potential to expand the kidney allograft pool to include the TR donor population. Precautionary blood conservation methods allow the informed and consenting TR individual to donate a kidney with acceptable risk and without compromise to donor or graft outcomes.
authors.affiliation: Division of Hepatobiliary/Pancreatic Surgery and Abdominal Organ Transplantation, Department of Surgery, Keck-USC School of Medicine, Los Angeles, CA 90033, USA. rod.mateo.usc@tenethealth.com
authors.forename: Rod
authors.initials: R
authors.lastname: Mateo
authors.forename: Randy
authors.initials: R
authors.lastname: Henderson
authors.forename: Nicolas
authors.initials: N
authors.lastname: Jabbour
authors.forename: Singh
authors.initials: S
authors.lastname: Gagandeep
authors.forename: Anne
authors.initials: A
authors.lastname: Goldsberry
authors.forename: Linda
authors.initials: L
authors.lastname: Sher
authors.forename: Yasir
authors.initials: Y
authors.lastname: Qazi
authors.forename: Robert R
authors.initials: RR
authors.lastname: Selby
authors.forename: Yuri
authors.initials: Y
authors.lastname: Genyk
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006085:Graft Survival; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011300:Preoperative Care; D016896:Treatment Outcome; D016312:Treatment Refusal