Elsevier

Transplantation Proceedings

Volume 44, Issue 1, January–February 2012, Pages 287-289
Transplantation Proceedings

Outcome
Long-term outcome
Changes in Quality of Life in Deceased Versus Living-Donor Kidney Transplantations

https://doi.org/10.1016/j.transproceed.2011.11.056Get rights and content

Abstract

Objective

In Japan, >80% of kidney transplantations (KTs) are performed from living donors because of a severe shortage of deceased donors. Moreover, >90% of deceased donors are non–heart-beating donors. In this study, we compared the quality of life (QOL) of the recipients between living- and deceased-donor KT performed in our hospital.

Methods

QOLs of 91 recipients (11 deceased donors and 80 living donors) were analyzed using the Short Form 36 before and 1, 2, and 3 years after KT. Changes in QOLs were compared between deceased-donor KT (group DD) and living-donor KT (group LD).

Results

In group DD, physical (PCS) and mental (MCS) component summary scores before transplantation were 43.7 and 48.7, respectively. PCS decreased to 35.3 at 1 year and 34.2 at 2 years, but increased to 52.6 at 3 years. MCS as 43.2 at 1 year, 52.2 at 2 years, and 44.5 at 3 years. In group LD, PCS and MCS before transplantation were 36.9 and 42.6, respectively. PCS increased to 43.3 at 1 year, 47.6 at 2 years, and 51.0 at 3 years, and MCS increased to 47.8 at 1 year, 50.1 at 2 years, and 49.6 at 3 years.

Conclusions

The recipients of living-donor KT showed an improvement of QOL immediately after transplantation. However, in the recipients of deceased-donor KT, physical QOL (PCS) decreased for 2 years after transplantation. The reasons seem to be long waiting period and the use of non–heart-beating donors in deceased-donor KT in Japan.

Section snippets

Patients and Methods

Ninety-one patients underwent kidney transplantation in our hospital from January 2004 to December 2007. Eleven patients underwent cadaveric kidney transplantation (group DD) and 80 patients underwent living-donor kidney transplantation (group LD). Among the 11 cadaveric kidney transplantations, only 1 transplant was performed from a brain-dead donor, and the other 10 were performed from non–heart-beating donors (NHBDs). The background of the patients is presented in Table 1. The mean age was

Results

In group DD, although PCS was low (43.7), MCS was comparatively maintained (48.7) before transplantation. All specific domains were >40. After transplantation, PCS decreased to 35.3 at 1 year and 34.2 at 2 years. Specific domains physical functioning and role physical were decreased to levels <40. However, PCS increased to 52.6 at 3 years, which was higher than the pretransplantation level. Although MCS decreased to 43.2 at 1 year, it recovered to 52.2 at 2 years and 44.5 at 3 years (Fig 1).

In

Discussion

Kidney transplantation has been established as an ultimate therapy for the patients with an end-stage renal disease. The outcome of kidney transplantation, including patient and graft survival, has been improved to a satisfactory level worldwide. Also in Japan, the results of kidney transplantation have improved from year to year. Five-year patient and graft survivals of recipients who underwent living-donor kidney transplantation from 2000 to 2007 have been reached 95.9% and 90.7%,

Conclusions

The recipients of living-donor kidney transplantation showed an improvement in QOL immediately after transplantation, which was maintained for years. However, in the recipients of cadaveric kidney transplantation, physical QOL expressed by PCS decreased for 2 years after transplantation. The reasons seem to be the following: In Japan, recipients have to wait >14 years before undergoing kidney transplantation, owing to a shortage of donors, and therefore have various complications before

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