Risks of living kidney donation: Current state of knowledge on outcomes important to donors

Krista L. Lentine, Ngan N. Lam, Dorry L. Segev

Research output: Contribution to journalArticlepeer-review

Abstract

In the past decade, there have been increasing efforts to better define and quantify the short- and long-termrisks of living kidney donation.Recent studies have expanded upon the previous literature by focusing on outcomes that are important to potential and previous donors, applying unique databases and/or registries to follow large cohorts of donors for longer periods of time, andcomparing outcomeswithhealthynondonor controls toestimate attributable risks of donation. Leading outcomes important to living kidney donors include kidney health, surgical risks, and psychosocial effects of donation. Recent data support that living donors may experience a small increased risk of severeCKDandESKDcompared withhealthynondonors. Formostdonors, the15-year riskof kidney failure is<1%, but for certain populations, such as young, black men, this risk may be higher. New risk prediction tools that combine the effects of demographic and health factors, and innovations in genetic risk markers are improving kidney risk stratification.Minor perioperative complications occur in 10%-20%of donor nephrectomy cases, but major complications occur in <3%, and the risk of perioperative death is <0.03%.Generally, living kidney donors have similar or improved psychosocial outcomes, such as quality of life, after donation compared with before donation and comparedwith nondonors.Although the donation process should befinancially neutral, living kidney donorsmay experience out-of-pocket expenses and lostwages thatmay ormay not be completely covered through regional or national reimbursement programs, and may face difficulties arranging subsequent life and health insurance. Living kidney donors should be fully informed of the perioperative and long-term risks before making their decision to donate. Follow-up care allows for preventative care measures to mitigate risk and ongoing surveillance and reporting of donor outcomes to inform prior and future living kidney donors.

Original languageEnglish (US)
Pages (from-to)597-608
Number of pages12
JournalClinical Journal of the American Society of Nephrology
Volume14
Issue number4
DOIs
StatePublished - Apr 5 2019

ASJC Scopus subject areas

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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