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21 May 2009

A comprehensive program of care for living kidney donors – experience and plans in one centre

A Kwiatkowski, P Domagała, M Bieniasz, R Kieszek, J Gozdowska, M Wszoła, A Jakubowska-Winecka, J Trzebicki, L Adadyński, D Wasiak, Ł Ostrowski, P Pruszczyk, D Kęcik, M Gołębiowski, M Durlik, L Pączek, A Chmura

Ann Transplant 2009; 14(1): 49-50 :: ID: 880380

Abstract

Background: Being a donor carries a risk associated with surgery and further
life with one kidney, thus renal transplantation from a living donor may only be performed if the donor's risk is low and probability of a successful transplant high. The aim of this study is to present our own experience in introducing a pioneering complex program of a living donor care in Poland.
Material/Methods: Between 1996 and 2007 our transplantation team performed ninety-one living donor nephrectomies. Beginning in 2005 we introduced a system of control assessments of the donors (group A). Medical examinations were carried out at 1, 3, 6 and 12 months following surgery and every 12 months thereafter. Beginning at the end of 2007, medical assessments of donors nephrectomised prior to 2005 were commenced (group B). Majority of group A donors responded to invitations for control assessments. A one-day hospitalization included medical history, physical examination, abdominal US, chest X-ray, peripheral blood count, C-reactive protein, urine microscopy and culture and functional tests of the remaining kidney. Most group B donors had not been followed up before the commencement of the program. The fi rst program visit, a 2-3 day hospital stay consisted of various tests and consultations, including blood and urine tests, abdominal US, chest X-ray, ABPM(ambulatory blood pressure monitoring),renal isotope scan, ECG, ophthalmological and nephrology consultation.
Results: Donors in both groups had significantly raised serum creatinine and creatinine clearance decreased by 25-35 ml/kg/1.73 m2. Both groups of donors were subjected to quality of life and pro-health behavioural assessment by standard questionnaires, in cooperation with a clinical psychology specialist.
Conclusions: Living kidney donors should be subjected to obligatory longterm follow-up. A comprehensive system of care for living kidney donors with regular multidisciplinary health check-ups and, if necessary, appropriate treatment provides the donors with a feeling of safety and is aimed at decreasing the number of long-term complications of becoming a donor.

Keywords: Kidney Transplantation, Living Donors

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358