TY - JOUR
T1 - Long-term risks of kidney living donation
T2 - review and position paper by the ERA-EDTA DESCARTES working group
AU - Maggiore, Umberto
AU - Budde, Klemens
AU - Heemann, Uwe
AU - Hilbrands, Luuk
AU - Oberbauer, Rainer
AU - Oniscu, Gabriel C
AU - Pascual, Julio
AU - Schwartz Sorensen, Soren
AU - Viklicky, Ondrej
AU - Abramowicz, Daniel
AU - ERA-EDTA DESCARTES working group
N1 - © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors, especially in those having first-degree relatives with ESRD. The study from Norway also found an increased risk of death after living donor nephrectomy, which became visible only after >15 years of post-donation follow-up. However, these findings are likely to be largely the result of an overestimation due to the confounding effect related to a family history of renal disease. DESCARTES board members emphasize the importance of optimal risk–benefit assessment and proper information to the prospective donor, which should also include recommendations on health-promoting behaviour post-donation.
AB - Two recent matched cohort studies from the USA and Norway published in 2014 have raised some concerns related to the long-term safety of kidney living donation. Further studies on the long-term risks of living donation have since been published. In this position paper, Developing Education Science and Care for Renal Transplantation in European States (DESCARTES) board members critically review the literature in an effort to summarize the current knowledge concerning long-term risks of kidney living donation to help physicians for decision-making purposes and for providing information to the prospective live donors. Long-term risk of end-stage renal disease (ESRD) can be partially foreseen by trying to identify donors at risk of developing ‘de novo’ kidney diseases during life post-donation and by predicting lifetime ESRD risk. However, lifetime risk may be difficult to assess in young donors, especially in those having first-degree relatives with ESRD. The study from Norway also found an increased risk of death after living donor nephrectomy, which became visible only after >15 years of post-donation follow-up. However, these findings are likely to be largely the result of an overestimation due to the confounding effect related to a family history of renal disease. DESCARTES board members emphasize the importance of optimal risk–benefit assessment and proper information to the prospective donor, which should also include recommendations on health-promoting behaviour post-donation.
U2 - 10.1093/ndt/gfw429
DO - 10.1093/ndt/gfw429
M3 - Review
C2 - 28186535
SN - 0931-0509
VL - 32
SP - 216
EP - 223
JO - Nephrology, Dialysis, Transplantation
JF - Nephrology, Dialysis, Transplantation
IS - 2
ER -