The health of elderly living kidney donors after donation.

BACKGROUND: Elderly donors may have increased risks in the peri- and post-transplant period. We performed a retrospective study to determine the outcome of elderly living donors in our center. MATERIAL/METHODS: Analysis of our live-related transplant program from Mar 1976 to Mar 2005 revealed that 146 donors were older than 50 years (range 50 to 69 yr) at the time of transplantation. We attempted to contact all donors to determine long-term outcome regarding their remaining kidney but 78 (53.4%) of them responded and were subjected to assessment. Their data were compared to the age matched health tables of the Egyptian general populations.
RESULTS: Most donors (85%) gave their kidneys to their offspring. Twenty four donors became hypertensive (30.8%) and nearly 62% received one drug only. Five donors were diabetics and 5 with arrhythmia. The mean serum creatinine at the follow up was 1.0+/-0.9 mg/dl. Five donors developed proteinuria, none of them with >2 gm/day. The rate of diabetes and hypertension was similar to the age matched general population.
CONCLUSIONS: Donor nephrectomy has minimal adverse effects on overall health status. Our data underscore the need to develop prospective trials for long-term follow up of elderly kidney donors.

Long-term follow-up of living kidney donors: a longitudinal study.

OBJECTIVE: To analyse retrospectively the general health status and renal and cardiovascular consequences of living-related kidney donation, as the long-term effects of unilateral nephrectomy for kidney donation are of particular interest with the currently increasing practice of living-donor transplantation. PATIENTS AND METHODS: Living-related kidney donors (1400) who had donated their kidneys between 1976 and 2002 were asked to attend a dedicated donor follow-up clinic starting in 2004. We attempted to contact all donors to determine the long-term outcome of their remaining kidney. All kidney donors who responded had a detailed assessment, and were questioned about rehabilitation and their feelings on donating a kidney. The data were compared to the age-matched health tables of the Egyptian general population. RESULTS: In all, 339 donors had a complete evaluation (mean age at the time of evaluation 47.8 years, sd 11; mean follow-up 10.7 years, sd 4.9). The mean (sd) creatinine level after donation was 1.1 (1.2) mg/dL, and creatinine clearance 109 (33) mL/min; the clearance was <60 mL/min in 0.9% of donors and proteinuria was >300 mg/24 h in 1.5% of donors. Seventy-five (22.1%) donors became hypertensive and the rate was higher in donors with an interval of >25 years from donation; 174 (51.3%) of patients became either overweight or obese. Diabetes mellitus developed in 23 (6.8%) and was more common in patients with significant weight gain. CONCLUSIONS: Donor nephrectomy has minimal adverse effects on overall health status. Regular donor follow-up identifies at-risk populations and potentially modifiable factors.