Living related donor nephrectomy in transfusion refusing donors

Area of Science:

• Nephrology
• Transplantation Surgery
• Immunology

Background:

• Many kidney transplant programs hesitate to evaluate potential donors who refuse blood transfusions.
• This reluctance may limit the donor pool for kidney allografts.

Purpose of the Study:

• To compare donor and graft outcomes between transfusion-consenting (TC) and transfusion-refusing (TR) live kidney donors.
• To determine if disallowing blood transfusions during live donor nephrectomy impacts outcomes.

Main Methods:

• Retrospective analysis of 82 live donor nephrectomies (July 1999-August 2005).
• Eight donors were transfusion-refusing (TR) and underwent procedures using blood conservation techniques.
• Comparison of donor demographics, surgical/functional outcomes, hematocrit, and creatinine between TC and TR groups.

Main Results:

• No donor mortalities occurred in either group.
• Intra-operative blood loss was significantly lower in TR donors (121 +/- 91 ml) compared to TC donors (298 +/- 412 ml).
• No significant differences were observed in donor demographics, intra-operative events, graft survival, or patient survival.

Conclusions:

• Live donor nephrectomy is feasible and safe for transfusion-refusing donors using blood conservation methods.
• Accepting transfusion-refusing donors can expand the kidney allograft donor pool.
• Outcomes for both donors and grafts are not compromised in transfusion-refusing individuals.