[The Swiss Organ Living Donor Health Registry (SOL-DHR)]

The Swiss Organ Living Donor Health Registry (SOL-DHR) started in April 1993. The purpose was the prospective and sequential follow up of donors long-term health. Between 1993 and January 2005 737 Living Kidney donations were registered and followed. Two thirds of donors were female and two thirds of recipients male. The three most common relations were life-partners, parents and siblings (approximately 30% each). 10% of donors could not be followed since living far abroad and 5% were lost due to missing current address after moving. 9 donors died (4 malignancies, 2 traffic accidents, 1 myocardial infarction, 1 stroke and 1 suicide), non due to kidney donation. Perioperative complications were age dependent, ranging from 17% in donors below the age of 40 year and 46% in donors older than 70 years. The longterm complications were divided in surgical, medical and psychological ones. The most common surgical long-term complications were pain (cicatrice, back, abdomen) and hernias. The major medical complications were hypertension (35% at seven years after donation) and rising rate of Albuminuria (9% at seven years). Although hypertension was not higher than in an age matched Swiss control population, untreated hypertension was regarded as the higher risk for development of glomerulosclerosis than in people with two kidneys. No donor went into end stage renal failure. Using the SF-8-Test to quantify the psychological well-being the mean MCS (mental component summary) was 54.3 +/- 7.8 as compared to 52.9 +/- 7.7 in the age matched control population. MCS was low (< 40) in 6.2% and very low (< 25) in 2.2% of donors. 94.4 % of donors would donate again, while 4.3% would not (mostly women). The reasons not to donate again was mainly related to poor outcome of the kidney recipient, or long-lasting major pain or disappointment about medical handling before (not enough information, wrong advice) and after organ donation. The association of Swiss Living Organ Donors, where only kidney or liver donors can become a member, are organising self-help-groups for pain, psychological and financial problems (with health insurances). The organisation and financial support of SOL-DHR is briefly described. The waste majority of living kidney donors are very satisfied about the free care given by SOL-DHR.