Kidney donor outcomes ≥ 50 years after donation

Area of Science:

• Nephrology
• Transplantation
• Gerontology

Background:

• Long-term data on living kidney donors (LDs) is limited, particularly for those donating at a young age.
• Understanding the long-term health trajectory of LDs is crucial for donor well-being and informed consent.

Purpose of the Study:

• To evaluate the long-term outcomes of living kidney donors (LDs) who donated at least 50 years ago.
• To assess mortality, causes of death, incidence of hypertension, diabetes, and proteinuria, and kidney function in this cohort.

Main Methods:

• Retrospective analysis of 66 living kidney donors (LDs) with a minimum of 50 years post-donation.
• Data collection included survival status, age at donation and death, causes of death, development of hypertension, diabetes, proteinuria, and estimated glomerular filtration rate (eGFR).
• Quality of life was assessed using the SF-36 health survey.

Main Results:

• Of 66 LDs, 22 are alive (mean age 78.5 years), 39 died (mean age 74.2 years), and 5 were lost to follow-up.
• Those who died were significantly older at the time of donation (P < .001).
• Common causes of death included cardiovascular diseases (30.8%), respiratory failures (23.0%), and malignancies (12.8%).
• Hypertension (74%), diabetes (18%), and proteinuria (16.7%) developed at rates similar to the age-matched general population.
• End-stage renal disease (ESRD) developed in 3.3% of LDs.
• Quality of life scores were comparable to the general population.

Conclusions:

• Living kidney donors (LDs) who donated kidneys 50 years ago exhibit long-term health outcomes and kidney function comparable to the general population.
• Older age at donation was associated with increased mortality in this cohort.
• The study underscores the safety of living kidney donation over the long term, with no significant increase in major health issues compared to non-donors.