Surgical techniques
Kidney transplantation with living donors: nine years of follow-up of 628 living donors

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Patients and methods

From January 1992 to June 2001, we performed 784 kidney transplants including 156 from cadaveric donors (19.9%), and 628 (80.1%) LD sources. Among the LD, 554 (88.3%) were obtained from living related donors (LRD) and 74 from living unrelated donors (LUD) most of them spouses (11.7%). We performed an open nephrectomy in all cases, choosing the right or left kidney based upon an evaluation performed by the Urology and Transplant Surgery Service. Donors were accepted despite risk factors

Results

The mean (±SD) follow-up was 80.7 ± 32.58 months (range 6 to 114 months); donor age, 34.5 ± 10.5 (range 18 to 64 years) including 319 men and 309 women. Among the series of LD, 422 patients had no risk factor; 206 patients, one or more risk factors including 42 with a high uric acid; 61, high cholesterol; 16, high blood arterial pressure; 81, BMI more than 30/m2; and six, with a more than 60 years of age at the time of donation. We did not consider multiple arteries as a risk factor for

Discussion

There are some pathologic conditions including aneurysms in the main renal artery and large cysts that are detected during the evaluation for donation. These patients receive a double benefit from donation: the detection and resolution of the pathology with good survival of the kidney transplant. Programs with high rates of living donation, as our center, must promote laparoscopic nephrectomy. In our series 80% of kidney donors had just one artery, a condition that is ideal for this procedure

Conclusions

In our series, donor risk factors did not influence outcomes to the end of the follow-up. Hypertension and age more than 60 years did not influence the short follow-up, but they were important at the end of follow-up with GFR values significantly lower than the control group (Table 2). In our transplant unit living donation is a safe procedure without deaths and with a low morbidity for major complications (0.3%), results that are similar to the series reported by Najarian et al from the

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