Are We Taking Proper Care of Living Donors? A Follow-up Study of Living Kidney Donors in Poland and Further Management Proposal

被引:7
|
作者
Rowinski, W. [1 ]
Chmura, A. [2 ]
Wlodarczyk, Z.
Ostrowski, M. [3 ]
Rutkowski, B. [4 ]
Domagala, P. [2 ]
Dziewanowski, K. [5 ]
Matych, J. [6 ]
Durlik, M. [2 ]
Grenda, R. [7 ]
机构
[1] Univ Warmia, Dept Med Sci, Olsztyn, Poland
[2] Med Univ Warsaw, Med Univ, Bydgoszcz, Poland
[3] Med Univ, Szczecin, Poland
[4] Med Univ, Gdansk, Poland
[5] Vojevodship Hosp, Szczecin, Poland
[6] Med Univ Lodz, Lodz, Poland
[7] Childrens Mem Hlth Inst, Warsaw, Poland
关键词
D O I
10.1016/j.transproceed.2008.08.140
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Objective. The first kidney transplantation was performed in Poland in 1966. Since that time approximately 11,000 patients have undergone the procedure, but most of them have received the kidney from deceased donors; only 342 procedures utilized living donors (LD; 2.7%). The aim of this study was to review the results of a LD follow-up in Poland. Patients and Methods. A questionnaire was sent to 11 centers that had performed 197 LD kidney transplantations during the last 10 years. The donors, who were all genetically or emotionally related, were 23 to 61 years old. No donor showed an abnormality regarding cardiovascular function or metabolic abnormalities. Results. The 6 centers that responded reported data on 118 donors. In 2 centers no donor follow-up was available. Eleven of 118 donors did not attend the control visits. Follow-up of the remaining donors ranged from 2 to 8 years. Four donors died at 4 to 5 years after nephrectomy due to cerebral hemorrhage, brain tumor, stomach cancer, or car accident, The overall mean serum creatinine had increased from 0.8 to 1.25 mg/dL, but 2 patients displayed a value > 2 mg/dL. The calculated creatinine clearance (MDRD formula) had decreased from 95 to 65 mL/min (P <.05). In 3 donors proteinuria (> 0.6 g/24 h) was observed at 3 to 5 years after donation. Of 3 patients who experienced mild hypertension, 2 required treatment. The remaining donors showed normal blood pressures. Conclusions. Since 2007, when the Living Donor Registry was introduced by law, transplant centers have been obliged to report data on each LD procedure together with follow-up data. All donors are life-insured (by Alianz SA) for 3 months from the time of transplantation. Stepwise interventional reno- and cardioprotection programs have been introduced after nephrectomy for LD, especially those with metabolic abnormalities at the time of donation.
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收藏
页码:79 / 81
页数:3
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