Renal Function in Sequential Living Kidney-Then-Liver Donors Undergoing Right Lobe Donation: A Two-Center Case Study

Area of Science:

• Nephrology
• Hepatology
• Transplant Surgery

Background:

• Concerns exist about living liver donation impacting kidney function in prior kidney donors.
• Limited data available on living liver donation outcomes following living kidney donation.
• Existing literature often focuses on left lobe grafts, not the prevalent right lobe grafts used in the US.

Purpose of the Study:

• To evaluate the safety of living liver donation on kidney function in individuals who have previously donated a kidney.
• To assess midterm outcomes for living kidney-then-liver donors.

Main Methods:

• Retrospective chart review of living liver donors with prior kidney donation at two US centers.
• Analysis of donor demographics, donation details, complications, and kidney function markers.
• Kidney volumetry to assess compensatory hypertrophy post-donation.

Main Results:

• 14 living kidney-then-liver donors were identified, primarily undergoing right lobe liver donation.
• Median follow-up was 24 months; median interval between donations was 32 months.
• Overall complication rate was 43%, with two donors experiencing stage 1 acute kidney injury (AKI) that resolved. Compensatory kidney hypertrophy was observed post-donation.

Conclusions:

• Right lobe living liver donation seems safe concerning midterm kidney function in prior kidney donors.
• Longer-term follow-up in a larger cohort is recommended for a comprehensive understanding of this donor group.