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Войти в исследования Kidney international reports · 2026
Long Term Outcomes in Living Kidney Donors Over 30 Years.
СтатьяНазвание и аннотация: Перевод в очереди
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Krättli Joana, Buess Deborah, Flohr Marie, Diebold Matthias, Wehmeier Caroline, Sidler Daniel, Beldi Guido, Golshayan Dela, Zingg Tobias, de Seigneux Sophie, Haidar Fadi, Ritter Alexander, Binet Isabelle, Hübel Kerstin, Rössler Fabian, Steiger Jürg, Hirt-Minkowski Patricia
Аннотация
INTRODUCTION: Living kidney donor transplantation provides major benefits for recipients, but long-term donor safety remains a critical concern.
METHODS: We conducted a prospective, multicenter cohort study using data from the Swiss Organ Living-Donor Health Registry. A total of 1863 living kidney donors (1993-2018) with ≥ 5 years of follow-up were followed until death, kidney failure (KF), or last visit (censoring March 31, 2024). Kidney function trajectories from 12 months postdonation onward were analyzed using linear mixed-effects models. A composite secondary end point included early death, dialysis-dependent KF, estimated glomerular filtration rate (eGFR) < 30 ml/min per 1.73 m2, or persistent proteinuria. Risk factors were assessed.
RESULTS: A total of 1863 living kidney donors (median age 53 years, 66.2% female) were included; 15.5% had treated arterial hypertension before donation. Median predonation eGFR was 96 ml/min per 1.73 m2, 1% had an eGFR < 60 ml/min per 1.73 m2. Median follow-up was 12 years (interquartile range [IQR]: 7-18 years). Kidney function remained stable, with an average annual eGFR change of +0.14 ml/min per 1.73 m2. Slopes differed by donor characteristics, as follows: women, nonobese, and those without predonation hypertension presented with more stable slopes, whereas obese and hypertensive donors showed attenuated slopes. No differences were observed by age or predonation eGFR. Three donors (0.2%) progressed to dialysis-dependent KF. Overall, 17 donors (0.9%) developed an eGFR < 30 ml/min per 1.73 m2, 28 (1.5%) developed persistent severe proteinuria, and 40 (2.1%) reached the combined end point. Male sex, age, and predonation obesity independently predicted the combined endpoint.
CONCLUSION: These findings support safety while underscoring the need for standardized long-term surveillance to optimize donor care and counseling.
METHODS: We conducted a prospective, multicenter cohort study using data from the Swiss Organ Living-Donor Health Registry. A total of 1863 living kidney donors (1993-2018) with ≥ 5 years of follow-up were followed until death, kidney failure (KF), or last visit (censoring March 31, 2024). Kidney function trajectories from 12 months postdonation onward were analyzed using linear mixed-effects models. A composite secondary end point included early death, dialysis-dependent KF, estimated glomerular filtration rate (eGFR) < 30 ml/min per 1.73 m2, or persistent proteinuria. Risk factors were assessed.
RESULTS: A total of 1863 living kidney donors (median age 53 years, 66.2% female) were included; 15.5% had treated arterial hypertension before donation. Median predonation eGFR was 96 ml/min per 1.73 m2, 1% had an eGFR < 60 ml/min per 1.73 m2. Median follow-up was 12 years (interquartile range [IQR]: 7-18 years). Kidney function remained stable, with an average annual eGFR change of +0.14 ml/min per 1.73 m2. Slopes differed by donor characteristics, as follows: women, nonobese, and those without predonation hypertension presented with more stable slopes, whereas obese and hypertensive donors showed attenuated slopes. No differences were observed by age or predonation eGFR. Three donors (0.2%) progressed to dialysis-dependent KF. Overall, 17 donors (0.9%) developed an eGFR < 30 ml/min per 1.73 m2, 28 (1.5%) developed persistent severe proteinuria, and 40 (2.1%) reached the combined end point. Male sex, age, and predonation obesity independently predicted the combined endpoint.
CONCLUSION: These findings support safety while underscoring the need for standardized long-term surveillance to optimize donor care and counseling.