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  • Title: Risks of living donor nephrectomy.
    Author: Santos L, Macário F, Alves R, Mota A, Campos M.
    Journal: Transplant Proc; 2010 Jun; 42(5):1484-6. PubMed ID: 20620459.
    Abstract:
    INTRODUCTION: There is good evidence that long-term graft survival is superior when living donors are used for kidney transplantation. Nevertheless, an assessment of potential risks associated with living donation is of particular interest. PATIENTS AND METHODS: In this single-center study, we evaluated the renal function of 31 kidney living donors (1997-2003) at 2-13.2 years after nephrectomy. The purpose of this study was to evaluate perioperative complications, renal function, new-onset proteinuria, and hypertension. RESULTS: Living related donation was performed in all cases. The average time after donation was 5.7 +/- 2.4 years. The mean age at nephrectomy was 46.3 +/- 9.0 years (range, 25-64), and 26 (83.9%) donors were females. Twelve patients (29%) were older than 50 years. The left kidney was used in 25 patients (80.6%). Surgical complications occurred in 2 patients. Glomerular filtration rate (GFR) decreased from 116.9 +/- 23 to 77.7 +/- 19.2 mL/min/1.73 m(2) (P < .001). Five patients (16.1%) developed a postdonation GFR between 50 and 60 mL/min/1.73 m(2). Patients with lower GFR values after uninephrectomy showed lower predonation values (P < .05). Older patients (>50 years) displayed lower postdonation GFR than younger ones. We did not observe an increased prevalence of low postdonation GFR over time nor significant differences in protein excretion and blood pressure. CONCLUSIONS: Living donor nephrectomy appears to be an acceptably safe intervention. Despite a reduction in GFR, the postdonation incidence of hypertension was low and proteinuria was not observed in any donor, even among previously hypertensive patients. Rigorous donor follow-up is recommended to identify persons at risk.
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