Safety of living donor kidney transplantation in elder donors or with potential medical risks

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Author:
QIU Jiang(Department of Kidney Transplantation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
CHEN Li-zhong(Department of Kidney Transplantation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
LI Jun(Department of Kidney Transplantation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
WANG Chang-xi(Department of Kidney Transplantation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
FEI Ji-guang(Department of Kidney Transplantation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
CHEN Guo-dong(Department of Kidney Transplantation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
HUANG Gang(Department of Kidney Transplantation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China)
Journal Title:
CHINESE JOURNAL OF BIOMEDICAL ENGINEERING
Issue:
Volume 15, Issue 04, 2009
DOI:
10.3760/cma.j.issn.1674-1927.2009.04.007
Key Word:
Kidney transplantation;Living donors;Glomerular filtration rate;Postoperative complications;Safety

Abstract: Objective To investigate the selection and safety of living kidney transplantation in elder donors or with potential medical risks. Methods A retrospective analysis of 66 living kidney donors in our hospital was performed. The donors were stratified into aged below 50 years group (n=42) and aged 50 years or above group (n=24) based on their age, and also into potential-risk group (group A, n=12) and non-risk group (group B, n=54) based on pre-operative evaluation. The length of hospital stay, pre- and post-operative glomerular filtration rate (GFR), serum creatinine (Scr) and complications were compared among the donors. Results The pre-operative GFR and pre-and post-operative Ser appeared to be comparable between the age-stratified groups (P>0.05). However, the 3-month post-operative GFR of the remaining kidney was (74.82±17.42) ml/min in the aged below 50 years old group vs (60.34±13.32) ml/min in the aged 50 years or above group (P<0.05). Donors aged above 55 years required longer hospital stay compared with those aged below 50 years (P<0.05). There was no significant difference in incidence of complications between the two groups (P>0.05). The risk-stratified groups showed similar levels of pre- and post-operative Scr, pre-operative and 3-month post-operative GFR (P>0.05). Conclusions Selection of donors with advanced age or potential medical risks need to be careful. Comprehensive evaluation before operation and rigorous criteria of inclusion should ensure good safety and favorable outcomes.

  • [1]Davis C.Evaluation of the living kidney donor:,current perspective.Am J Kidney Dis,2004,43:508-530.
  • [2]Davis CL,Delmcuico FL.Living-donor kidney transplantation:a review of the current practices for the live donor.J Am Soc Nephrol,2005,16:2098-2110.
  • [3]陈正,潘光辉,廖德怀.等.老年活体亲属供肾移植的安全性分析.中华泌尿外科杂志,2008.29:21-25.
  • [4]European Expert Group on Renal Transplantation.European best practice guidelines for renal transplantation (part 1).Nephrol Dial Transplant,2000,15:47-58.
  • [5]Kasiske BL,Ravenseraft M,Ramos EL,et al.The evaluation of living renal transplant donor,clinical practice guidelines.Ad Hoc Clinical Practice Guidelines Subcommitee of the Patient Care and Education Committee of the American Society of Transplant Physicians.J Am Soc Nephrol,1996,7:2288-2313.
  • [6]Gonwa TA,Atkins C,Zhang YA,et al.Glomerular filtration rates in persons evaluated as living-related douors--are our standards too high? Tansplantation,1993,55:983-985.
  • [7]Iseki K,lseki C,lkemiya Y,et al.Risk of developing end-stage renal disease in a cohort of mass screening.Kidney Int,1996,49:800-805.
  • [8]Wang YY,Wang QJ.The prevalence of prehypertension and hypertension among US adults according to the new joint national committee guidelines:new challenges of the old problem.Arch Intern Med,2004,164:2126-2134.
  • [9]Textor SC,Taler SJ,Driscoll N,et al.Blood pressure and renal function after kidney donation from hypertensive living donors.Transplantation,2004,78:276-282.
  • [10]Tozawa M,Iseki K,Iseki C,et al.Influence of smoking and obesity on the development of proteinuria.Kidney Int,2002,62:956-962.
  • [11]Iseki K,Ikemiya Y,Iseki C,et al.Proteinuria and the risk of developing end-stage renal disease.Kidney Int,2003,63:1468-1474.
  • [12]Iseki K,Ikemiya Y,Kinjo K,et al.Body mass index and the risk of development of end-stage renal disease in a screened cohort.Kidney Int,2004,65:1870-1876.
  • [13]Parmar M.Kidney stones.BMJ,2004,328:1420-1424.
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