Perioperative Complications During Living Donor Nephrectomy: Results From a Multicenter Cohort Study

Area of Science:

• Nephrology
• Transplant Surgery
• Public Health

Background:

• Living kidney donation is generally safe for healthy individuals.
• Perioperative complications can occur in living kidney donors.
• Factors influencing these complications require further investigation.

Purpose of the Study:

• To explore associations between perioperative complications and donor characteristics, surgical technique, and surgeon experience.
• To analyze complication rates in a large cohort of living kidney donors.
• To identify risk factors for perioperative complications in living kidney donation.

Main Methods:

• A multicenter cohort study involving living kidney donors and surgeons in Canada and Australia.
• Prospective collection of operative and discharge notes, with retrospective abstraction of perioperative data.
• Analysis using multivariable logistic regression and Poisson regression, with surgeon characteristics assessed via a retrospective online survey.

Main Results:

• 13% of 1042 living kidney donors experienced perioperative complications, mostly minor (90%).
• Major complications occurred in 1% of donors; no perioperative deaths were reported.
• No statistically significant differences in complication rates were found based on donor characteristics, surgeon experience, or center volume.

Conclusions:

• Living kidney donation remains a safe procedure with a low incidence of major perioperative complications.
• No specific donor or surgeon factors were identified as significantly increasing the risk of complications in this cohort.
• Limitations include non-standardized reporting and retrospective surgeon surveys, suggesting potential for missed complications.