title: Death of recipients after kidney living donation triples donors' risk of dropping out from follow-up: a retrospective study.
abstract: Although kidney transplantation from the donation of a living donor is a safe treatment for end-stage renal disease, inferences about safety of living kidney donors might be biased by an informative censoring caused by the noninclusion of a substantial percentage of donors lost to follow-up. With the aim of assessing the presence of a potential informative censoring in living kidney donation outcomes of Catalan donors for a period of 12 years, 573 donors followed and lost to follow-up were compared. Losses of follow-up over time were also assessed by univariate and multivariate survival analysis, along with Cox regression. Younger and older ages, and the death of their recipient differentiated those donors who were lost to follow-up over time. The risk of dropping out from follow-up was more than twofold for the youngest and oldest donors, and almost threefold for those donors whose recipient died. Results of studies on postdonation outcomes of Catalan living kidney donors might have overlooked older and younger cases, and, remarkably, a percentage of donors whose recipient died. If these donors showed a higher incidence of psychological problems, conclusions about living donors' safety might be compromised thus emphasizing the necessity of sustained surveillance of donors and prompt identification of these cases.
authors.affiliation: Psychiatry and Clinical Psychology Service, Institut Clínic de Neurociències, Hospital Clínic de Barcelona, Barcelona, Spain.
authors.forename: Xavier
authors.identifier: http://orcid.org/0000-0002-7442-8750
authors.initials: X
authors.lastname: Torres
authors.affiliation: Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Comas
authors.affiliation: Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain.
authors.forename: Emma
authors.initials: E
authors.lastname: Arcos
authors.affiliation: Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain.
authors.forename: Jaume
authors.initials: J
authors.lastname: Tort
authors.affiliation: Department of Nephrology and Kidney Transplantation, Hospital Clínic de Barcelona, Barcelona, Spain.
authors.forename: Fritz
authors.initials: F
authors.lastname: Diekmann
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods / Q000401:mortality*; D019520:Living Donors / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts / Q000523:psychology*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D061349:Unrelated Donors / Q000523:psychology
keywords: donor registries; follow-up; live donors; outcome; recipient death