20 years or more of follow-up of living kidney donors

Najarían, John S.; McHugh, Lois; Matas, Arthur J.; Chavers, Blanche M.

doi:10.1016/0140-6736(92)92683-7

Cited by 556 publications

(292 citation statements)

References 22 publications

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“…More specific analysis for donors, however, has not been performed. (17,58,59) with the most recent paper by Garg (8) reporting a 10-year rate of 16%, which is ϳ5% above the control population. Furthermore, the U.S. and potential donor population is aging.…”

Section: Donor Mortalitymentioning

confidence: 99%

The State of U.S. Living Kidney Donors

Davis¹,

Cooper²

2010

Clinical Journal of the American Society of Nephrology

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Conclusions: Almost one quarter of living donors have medical conditions that may be associated with future health risk. Close follow-up and a registry of these donors are necessary. Only then will we be able to inform prospective living donors most accurately of the real risk of donation on their health and survival. Additionally, these data speak to the need for a national discussion on the provision of health insurance for living donors.

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Section: Donor Mortalitymentioning

confidence: 99%

The State of U.S. Living Kidney Donors

Davis¹,

Cooper²

2010

Clinical Journal of the American Society of Nephrology

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“…Bu düşüncenin oluşmasındaki en önemli sebep 20 yıldan fazla takip edilen donör nefrektomi yapılan hastalarda normal popülasyona kıyasla daha fazla oranda herhangi bir ciddi hastalık, diyaliz ihtiyacı gerektirecek böbrek yetmezliği ve ölüm görülmediğinin bildirilmiş olması gerçeğidir (12). Böbrek donörleri ile böbrek tümörlü hastalar arasında dikkat edilmesi gereken önemli bir nüans, donörler pek çok komorbidite açısından taranmış, dikkatle seçilmiş sağlıklı ve sıklıkla genç (<40 yaş) insanlar iken, böbrek tümörlü hastalar bu durumun tam tersi olarak, genellikle daha yaşlı ve sıklıkla metabolik sendrom, hipertansiyon, koroner arter hastalığı, obezite ve diyabet gibi böbrek fonksiyonunu da etkileyebilecek çok çeşitli komorbiditelerden bir veya birkaçına sahiptirler.…”

Section: Discussionunclassified

The Effects of Radical Nephrectomy and Nephron Sparing Surgery on Glomerular Filtration Rate for the Patients who Underwent Surgery for Localized Renal Mass

Güdeloğlu¹,

Akdoğan²

2016

Acta Oncol Tur.

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ÖZETAmaç: Bu çalışmada, radikal nefrektomi (RN) ile nefron koruyucu cerrahinin (NKC) uzun dönem böbrek fonksiyonları üzerine etkisini ortaya koymak amaçlanmıştır. Hastalar veYöntem: Hacettepe Üniversitesi Tıp Fakültesi Üroloji Anabilim Dalı'nda Ocak 1990 -Nisan 2011 tarihleri arasında renal kitle nedeniyle ameliyat edilen 1016 hastaya ait veriler, retrospektif olarak incelenmiştir. Tanı anında metastatik olduğu bilinen 78 olgu çalışma dışı tutulmuştur. Bulgular: Çalışmaya alınan olguların 579'u (%61,7) erkek ve 359'u (%38,3) kadındır. 624 olguya RN, 314 olguya NKC yapılmıştır. Hastaların ortalama takip süresi RN yapılan grupta 46.7 ay iken, NKC uygulanan grupta 39.9 aydır. Ortalama radyolojik tümör boyutu sırasıyla 75±33,5 mm ve 37,8±26 mm'dir (p<0.001). Ortalama ameliyat süresi RN ve NKC grupları için sırasıyla 137.6 ve 139.5 dakikadır. NKC uygulanan grupta ortalama sıcak iskemi süresi 18,9±6,8 (3-36) dakikadır. Uzun dönem takip sonunda RN yapılan gruptaki kreatinin değerindeki ortalama 0,51 mg/dl artış, NKC uygulanan gruptaki 0,39 mg/dl artıştan anlamlı şekilde daha fazladır (p<0.001). Uzun dönem takipte preoperatif GFR'ı ≥60 olan hastaların halen GFR değerinin ≥60 olarak devam etme oranları, RN ve NKC yapılan gruplarda sırasıyla %47.6 ve %74.8 olarak tespit edilmiştir (p<0.001). Sonuç: Çalışmamızda GFR'de azalma oranının uzun dönemde RN yapılan hastalarda NKC yapılanlara göre daha fazla olduğu bulunmuştur. T1 renal tümörü olan birçok olguda RN ile bütün böbreği çıkarmak fazladan tedavidir. T1 renal tümörü olan hastalarda teknik olarak mümkün oldukça parsiyel nefrektomi tercih edilmelidir. Anahtar kelimeler: Renal Hücreli Karsinom, Radikal Nefrektomi, Nefron Koruyucu Cerrahi, Glomerüler Filtrasyon Oranı ABSTRACT Objectives: The goal of this study was to demonstrate the long-term effects of radical nephrectomy (RN) and nephron sparing surgery (NSS) on kidney functions. Patients and Methods: The medical records of 1016 patients who underwent kidney surgery from January 1990 to April 2011 at Hacettepe University School of Medicine, Department of Urology were retrospectively collected and analyzed. Metastatic 78 patients at presentation were excluded. Results: Radical nephrectomy and nephron sparing surgery was performed in 624 and 314 cases, respectively. Male to female ratio was 579/314. The mean follow up was 46.7 and 39.9 months for RN and NSS, respectively. The mean radiological tumor size was 75±33,5 mm for RN and 37,8±26 mm for NSS (p<0.001). The mean duration of surgery for RN and NSS was 137 and 139 minutes, respectively. The mean warm ischemia time for NSS was 18.9 minutes. Serum creatinin level was increased 0.51mg/dl and 0.39mg/dl for RN and NSS after long-term follow up, respectively (p<0.001). Glomerular filtration rate (GFR) was ≥ 60 ml/min/m 2 in 47.6% and 74.8% of RN and NSS patients in long-term follow up, respectively (p<0.001). Conclusion: Decrease in GFR was more prominent in RN compared to NSS patients in long term. Therefore, removing the whole kidney for especially T1 renal tumours is over ...

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“…When one of two kidneys is donated, the effect on the average donor's health is certainly limited in the short term and in the long term, but the procedure is not without risk [2,3,4,5,6,7,81. To be able to make a voluntary decision a person's autonomy must be respected.…”

Section: Introductionmentioning

confidence: 99%

Written information for potential living kidney donors

Lennerling¹,

Nyberg²

2004

Transpl Int

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To meet the constantly growing demand for organs for transplantation the use of living related and unrelated donors continues to increase. Transplant units with a living-donor programme often provide written information to their potential kidney donors. We saw a need to assess the contents of these brochures. Written information for potential live kidney donors was requested from different Transplant units throughout the world. We obtained and analysed 16 different brochures from 14 countries. The general approach ranged from persuasive to almost deterring. Sixteen main themes were identified in the information material. Eight of those were considered paramount, namely voluntarism, medical suitability, short-term donor risks, longterm donor risks, risk of graft loss, outcome with and without a living donor, postoperative course, and financial conditions. Five brochures covered a11 these crucial matters. When mentioned, examples and interpretations of donor risks were very dissimilar. Furthermore, the conditions for donation were obviously very different in the various countries. This review points at essential issues to be included in the written information for living kidney donors. All transplant units with a living-donor programme should provide such information, thus enabling the potential donor to make a thorough decision.

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20 years or more of follow-up of living kidney donors

Cited by 556 publications

References 22 publications

The State of U.S. Living Kidney Donors

The State of U.S. Living Kidney Donors

The Effects of Radical Nephrectomy and Nephron Sparing Surgery on Glomerular Filtration Rate for the Patients who Underwent Surgery for Localized Renal Mass

Written information for potential living kidney donors

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