Are we taking proper care of living donors? A follow-up study of living kidney donors in Poland and further management proposal.
OBJECTIVE
The first kidney transplantation was performed in Poland in 1966. Since that time approximately 11,000 patients have undergone the procedure, but most of them have received the kidney from deceased donors; only 342 procedures utilized living donors (LD; 2.7%). The aim of this study was to review the results of a LD follow-up in Poland.


METHODS
A questionnaire was sent to 11 centers that had performed 197 LD kidney transplantations during the last 10 years. The donors, who were all genetically or emotionally related, were 23 to 61 years old. No donor showed an abnormality regarding cardiovascular function or metabolic abnormalities.


RESULTS
The 6 centers that responded reported data on 118 donors. In 2 centers no donor follow-up was available. Eleven of 118 donors did not attend the control visits. Follow-up of the remaining donors ranged from 2 to 8 years. Four donors died at 4 to 5 years after nephrectomy due to cerebral hemorrhage, brain tumor, stomach cancer, or car accident. The overall mean serum creatinine had increased from 0.8 to 1.25 mg/dL, but 2 patients displayed a value >2 mg/dL. The calculated creatinine clearance (MDRD formula) had decreased from 95 to 65 mL/min (P < .05). In 3 donors proteinuria (>0.6 g/24 h) was observed at 3 to 5 years after donation. Of 3 patients who experienced mild hypertension, 2 required treatment. The remaining donors showed normal blood pressures.


CONCLUSIONS
Since 2007, when the Living Donor Registry was introduced by law, transplant centers have been obliged to report data on each LD procedure together with follow-up data. All donors are life-insured (by Alianz SA) for 3 months from the time of transplantation. Stepwise interventional reno- and cardioprotection programs have been introduced after nephrectomy for LD, especially those with metabolic abnormalities at the time of donation.
Rowinski
W
W
Department of Medical Sciences, University of Warmia, Olsztyn, Poland.
Chmura
A
A
Włodarczyk
Z
Z
Ostrowski
M
M
Rutkowski
B
B
Domagała
P
P
Dziewanowski
K
K
Matych
J
J
Durlik
M
M
Grenda
R
R
D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology; D019520:Living Donors; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods* / Q000592:standards; D009765:Obesity / Q000209:etiology; D011044:Poland; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000379:methods / Q000592:standards
D003404:Creatinine