Korean J Transplant.  2022 Nov;36(Supple 1):S42. 10.4285/ATW2022.F-1562.

Risk and outcomes after living donor nephrectomy in Korea: 15-year single center outcome

• Jang E
• Park SC
• Yun SS
• Lee YJ
• Moon KY
• Lee S
• Kim W
• Choi B

• KMID: 2535246
• DOI: http://doi.org/10.4285/ATW2022.F-1562

Abstract

Background
Living-donor kidney transplantation tend to be more common in Asian countries. Previous studies have shown that donor nephrectomy does not increase operation-related mortality or end-stage renal disease (ESRD) risks in usual healthy donors. However, these results were based on studies performed in western countries, and only few results have been reported in the Asian population including Korea. We aimed to analyze the short and long-term risks of living kidney donors in Korea.
Methods
We retrospectively analyzed medical records of 1,352 patients who had undergone donor nephrectomy from August 2005 to December 2020 at Seoul St. Marys Hospital. We collected baseline characteristics such as obesity, hypertension, dyslip-idemia, diabetes, and GFR. Immediate postoperative complications were graded according to the Clavien-Dindo classification. Hemoglobin, BUN, Cr, GFR, proteinuria, glucose, cholesterol, and triglyceride levels were assessed at regular follow-up intervals. Long-term mortality and incidence of comorbidities were also assessed.
Results
Of the 1,352 patients, 740 patients had 5-year follow-up results, and 137 patients had 10-year follow-up results. Five (0.4%) patients had severe postoperative complications; one patient requiring ICU care due to postoperative bleeding. Before donation, 3.0% were hypertensive, 4.7% had dyslipidemia, and 0.1% were diabetic. After donation, 5.8% were hypertensive, 4.9% had dyslipidemia, and 0.1% had diabetes. All donors had eGFR above 60 mL/min/1.732 before nephrectomy, but 19.7% donors showed eGFR below 60 after long-term follow-up, and 4.9% reached eGFR below 40. No mortality or ESRD requiring hemodialy-sis were reported during follow-up.
Conclusions
Donor nephrectomy is a safe procedure with low risk of operation related complications. There was no significant difference in renal function, or cardiovascular comorbidities in donors compared to the healthy population. Limitations of our study was that the donors were from a single center, and many were lost during follow-up. Further studies including data from donors before 2005 may show additional outcomes, on mortality and renal failure.