Early Complications in Kidney Donors and Course of Health-related Quality of Life 12 mo After Donation: An Analysis of the Swiss Organ Living-Donor Health Registry

Charlotte Brügger, MS; Zoé Hunkeler, MS; Matthias Diebold, MD; Joana Krättli, MD; Irene Geiger, Lic Phil; Caroline Wehmeier, MD; Thomas Wolff, MD; Bruno Vogt, MD; Federico Storni, MD; Dela Golshayan, MD, PhD; Tobias Zingg, MD; Sophie de Seigneux, MD; Fadi Haidar, MD; Isabelle Binet, MD; Aurelia Schnyder, MD; Kerstin Hübel, MD; Thomas Müller, MD; Fabian Rössler, MD; Jürg Steiger, MD; Patricia Hirt-Minkowski, MD

doi:10.1097/TXD.0000000000001716

Transplantation Direct (Nov 2024)

Early Complications in Kidney Donors and Course of Health-related Quality of Life 12 mo After Donation: An Analysis of the Swiss Organ Living-Donor Health Registry

Charlotte Brügger, MS,
Zoé Hunkeler, MS,
Matthias Diebold, MD,
Joana Krättli, MD,
Irene Geiger, Lic Phil,
Caroline Wehmeier, MD,
Thomas Wolff, MD,
Bruno Vogt, MD,
Federico Storni, MD,
Dela Golshayan, MD, PhD,
Tobias Zingg, MD,
Sophie de Seigneux, MD,
Fadi Haidar, MD,
Isabelle Binet, MD,
Aurelia Schnyder, MD,
Kerstin Hübel, MD,
Thomas Müller, MD,
Fabian Rössler, MD,
Jürg Steiger, MD,
Patricia Hirt-Minkowski, MD

Affiliations

Charlotte Brügger, MS: 1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
Zoé Hunkeler, MS: 1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
Matthias Diebold, MD: 1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
Joana Krättli, MD: 2 Swiss Organ Living-Donor Health Registry (SOL-DHR), University Hospital Basel, Basel, Switzerland.
Irene Geiger, Lic Phil: 2 Swiss Organ Living-Donor Health Registry (SOL-DHR), University Hospital Basel, Basel, Switzerland.
Caroline Wehmeier, MD: 1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
Thomas Wolff, MD: 3 Vascular Surgery and Organ Transplantation Clinic, University Hospital Basel, Basel, Switzerland.
Bruno Vogt, MD: 4 Department for Nephrology and Hypertension, University Hospital Insel, Berne, Switzerland.
Federico Storni, MD: 5 University Clinic for Visceral Surgery and Medicine, University Hospital Insel, Berne, Switzerland.
Dela Golshayan, MD, PhD: 6 Transplantation Center, Department for Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Tobias Zingg, MD: 7 Department of Visceral and Transplant Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
Sophie de Seigneux, MD: 8 Nephrology and Hypertension Division, University Hospital Geneva (HUG), Geneva, Switzerland.
Fadi Haidar, MD: 8 Nephrology and Hypertension Division, University Hospital Geneva (HUG), Geneva, Switzerland.
Isabelle Binet, MD: 9 Clinic for Nephrology and Transplantation Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Aurelia Schnyder, MD: 9 Clinic for Nephrology and Transplantation Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
Kerstin Hübel, MD: 10 Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.
Thomas Müller, MD: 10 Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.
Fabian Rössler, MD: 11 Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.
Jürg Steiger, MD: 1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
Patricia Hirt-Minkowski, MD: 1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.

DOI: https://doi.org/10.1097/TXD.0000000000001716
Journal volume & issue: Vol. 10, no. 11
p. e1716

Abstract

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Background. Since 1998, the Swiss Organ Living-Donor Health Registry (SOL-DHR) has recorded peri- and postoperative complications of living kidney (LK) donors, as reported by all Swiss transplant centers and has collected follow-up data prospectively. Methods. We analyzed the early complications of 2379 consecutive individuals who donated a kidney between January 1998 and June 2022 and assessed their health-related quality of life (HRQoL) 1 y after donation. Results. In total, 447 early complications in 404/2379 LK donors (17.0%) were reported to the SOL-DHR. The frequency of donors with major complications (ie, Dindo-Clavien classification 3/4) was 2.4%. In total, 31 donors needed reoperation, and in 13/31 (42%), donors reoperation was necessary because of bleeding complications. Independent risk factors for major early complications were older donor age (P = 0.005) and type of surgical approach (ie, the laparoscopic retroperitoneal compared with laparoscopic transabdominal surgery; P = 0.01), but not sex. We observed a U-shaped association of body mass index, where very low/high body mass indexes had higher odds of major early complications, without reaching statistical significance. Although HRQoL was affected by kidney donation, 96.5% of donors indicated that they would donate their kidney again. The only independent risk factor for low HRQoL based on mental health scores was worsening EB after living kidney donation (P < 0.0001). Conclusions. Overall, living kidney donation is a safe procedure, however, donor age and type of surgical approach affect the risk of complications. A decline in emotional bonding with the recipient after donation may worsen the quality of life of the donor.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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