Living kidney donation: donor risks and quality of life

This review describes the immediate and long-term risks to kidney donors. We reviewed their perioperative morbidity and mortality as well as their quality of life after donation. The overall mortality in our series was zero. Nationally, donor mortality has been estimated to be 0.03% (5). Our overall complication rate was 8.2% with only 2 (0.2%) complications considered to be major (16). Complications were associated with male sex, body weight > or = 100 kg, and inadvertent entry into the pleura during the donor operation. Most of our donors were discharged from the hospital in < 5 days. Risk factors for a longer hospital stay were age 50 or older and an operative time of 4 hours or more. The average donor quality of life after donation, as measured by the SF-36, was better than that of the general US population. This finding persisted for years after donation. The vast majority of our donors found the experience to be very rewarding and would readily donate again if it were possible. However, 4% were dissatisfied and regretted their decision to donate a kidney; these were most likely to be donors other than a first-degree relative and donors whose recipient died within the first posttransplant year. Living donation of kidneys appears to be relatively safe, with very few physical and psychologic complications. It may even improve the donor's quality of life. Living donors are an underutilized source of kidneys. We continue to advocate and encourage living kidney donation.