Risk factors for loss to follow‐up and outcomes after kidney donation in New Caledonian living donors

• Published in: Nephrology (Carlton, Vic.) Vic.), 2023-03, Vol.28 (3), p.187-195
• Main Authors: Baroux, Noémie, Gilles, David De Saint, Lamy, Thomas, Biche, Véronique, Wyburn, Kate, Quirin, Nicolas
• Format: Article
• Language: English
• Subjects: end‐stage kidney disease; follow up; Follow-Up Studies; Humans; Kidney; Kidney diseases; Kidney transplantation; Kidney Transplantation - adverse effects; living donor transplantation; Living Donors; living kidney donors; Middle Aged; Multivariate analysis; Nephrectomy - adverse effects; Nephrology; pacific islands; Retrospective Studies; Risk Factors; transplantation
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.14143

Aim For patients with end‐stage kidney disease, living‐donor kidney transplantation is the best therapy. There is a duty to ensure that the donor is followed‐up after donation on a regular and long‐term basis. Conditions may arise, such as hypertension, chronic kidney disease, metabolic conditions, and these should be identified and treated as soon as possible for the donor's own longer term wellbeing. In this retrospective cohort study, we investigated the risk of loss to follow‐up after kidney donation for living donors. Methods Data were collected from the unique Caledonian nephrology medical record software and a phone survey. We evaluated the association between being lost to follow up and donor recipient relationship, donor socio‐demographic characteristics, donation characteristics and care access. We performed a multivariate analysis to identify risk factors of loss to follow‐up. Results Among the the 86 donors included, 38 (44%) had no nephrology consultation for more than 16 months. The rate of donor follow up decreased from 81% at 2 years to 49% at 10 years after donation. In the multivariate analysis, age less than 45 years old at donation increased the risk of loss to follow up to 4.5 (95% CI 2.0–10.3) and not being a spouse increased the risk to 3.9 (95% CI 1.5–11.1). Conclusion To conclude, efforts should be made to improve the rate at which donors are followed up in New Caledonia with special attention to younger donors and donors without a marital link with the recipient. Summary at a Glance The primary aim of this single centre retrospective study was to identify living kidney donor risk factors associated with loss to follow‐up. The study was based on 86 donors at a transplant program serving remote islands in the South Pacific.