title: Effects of nephrectomy on respiratory function and quality of life of living donors: a longitudinal study.
abstract: BACKGROUND
  A living donor transplant improves the survival and quality of life of a transplant patient. However, the impact of transplantation on postoperative lung function and respiratory muscular strength in kidney donors remains unknown.
  
  
  OBJECTIVE
  To evaluate pulmonary function, respiratory muscle strength, quality of life and the incidence of postoperative pulmonary complications (PPCs) in kidney donors undergoing nephrectomy.
  
  
  METHODS
  This prospective cohort enrolled 110 consecutive kidney donors undergoing nephrectomy. Subjects underwent pulmonary function (using spirometry) and respiratory muscular strength (using manovacuometry) assessments on the day prior to surgery and 1, 2, 3 and 5 days postoperatively. Quality of life (measured by the SF-36) was evaluated preoperatively and 30 days postoperatively. PPCs were assessed daily by a blinded assessor.
  
  
  RESULTS
  Donors exhibited a decrease of 27% in forced vital capacity, 58% in maximum inspiratory capacity and 51% in maximum expiratory pressure on the 1stpostoperative day (p<0.001) but this improved over days 2, 3 and 5 but had not returned to preoperative levels. Patient quality of life was still impaired at 30 days with regards to functional capacity, physical role, pain, vitality and social functioning (p<0.05) but these parameters improved slowly. None of the patients developed PPCs.
  
  
  CONCLUSIONS
  Kidney donors submitted to nephrectomy exhibited a reduction in pulmonary function, respiratory muscular strength and quality of life, most of which were improving toward pre-surgical levels.
authors.affiliation: Universidade Cidade de São Paulo, São Paulo, SP, BR.
authors.forename: Karen
authors.initials: K
authors.lastname: Moraes
authors.affiliation: Departamento de Fisioterapia, Escola de Medicina, Universidade de São Paulo, São Paulo, SP, BR.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Paisani
authors.affiliation: Universidade Cidade de São Paulo, São Paulo, SP, BR.
authors.forename: Nathália C T
authors.initials: NC
authors.lastname: Pacheco
authors.affiliation: Universidade Cidade de São Paulo, São Paulo, SP, BR.
authors.forename: Luciana D
authors.initials: LD
authors.lastname: Chiavegato
mesh_terms: D006801:Humans; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology*; D009392:Nephrectomy; D011183:Postoperative Complications / Q000503:physiopathology*; D011788:Quality of Life; D012119:Respiration; D012132:Respiratory Muscles / Q000503:physiopathology*