Clinical research and social status investigation for donor and recipient of living-related kidney transplant

• Published in: International urology and nephrology 2013-02, Vol.45 (1), p.239-249
• Main Authors: Xue, Wujun, Tian, Puxun, Ding, Xiaoming, Pan, Xiaoming, Yan, Hang, Hou, Jun, Feng, Xinshun, Xiang, Heli, Tian, Xiaohui, Ren, Li, Zheng, Jin, Li, Shengbin
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Analysis of Variance; Blood Urea Nitrogen; Creatinine - blood; Delayed Graft Function - blood; Delayed Graft Function - etiology; Directed Tissue Donation; Donor Selection; Female; Graft Rejection - blood; Graft Rejection - immunology; Graft Survival; Histocompatibility Testing; Humans; Kidney - diagnostic imaging; Kidney - physiology; Kidney Diseases - surgery; Kidney Transplantation - adverse effects; Male; Medicine; Medicine & Public Health; Middle Aged; Nephrectomy; Nephrology; Nephrology - Original Paper; Nuclear Family; Risk Assessment; Ultrasonography; Urology; Young Adult
• ISSN: 0301-1623; 1573-2584
• DOI: 10.1007/s11255-012-0259-0

Objective Renal transplantation is the best options for treating end-stage renal disease. Better patient and allograft survival rates are provided by living donation, which has been safe, with minimal immediate and long-term risk for the donor. This study aims to investigate the life status and summarize the clinical experience in living-related kidney transplant (LRKT) before and after renal transplantation. Methods A total of 310 cases of LRKT have been performed in our center since 1998. Tissue matching and risk factors assessment in donors and recipients were performed before donation. Small lumbar incision was used in all cases for unilateral nephrectomy. Donors and recipients were followed up regularly after renal transplantation. Results All living donors were healthy, with normal renal function after unilateral nephrectomy. The 1- and 5-year patient/graft survival rates of LRKT were 98.3 %/97.6 % and 91.3 %/86.9 %, respectively. The cumulative incidence of delayed graft function (DGF) and acute rejection (AR) was 2.9 % (9 cases). Thirteen cases developed pulmonary infection (4.2 %) and eight cases were cured. The graft function in most cases returned to normal range soon after kidney transplant. Moreover, the creatinine and BUN levels of grafts donated by children or siblings of recipients were markedly lower than those donated by parents, at 1 month after transplant. Conclusion Adequate pretransplant assessment, better tissue matching, and reduced ischemia time may result in lower incidence of DGF, AR and higher patient/graft survival rates for LRKT. It is important to improve selection criteria and health assessment of donors. Long-term follow-up is essential to ensure a healthy life for donors and recipients after kidney transplant.