Hello everyone, our “Fudan University Zhongshan Hospital Kidney Transplantation” public account will do a series of popular science this time to talk about all aspects of living related kidney transplantation (abbreviated as “relative kidney transplantation”).
For related kidney transplantation, one of the most concerned issues is the safety of the kidney donor. After all, many people still have concerns and worries about removing a healthy kidney from their own body.
Facts speak louder than words. Let’s take a look at the data from abroad.
In this popular science article, we mainly quote a review published in the journal Nephrology, Transplantation and Dialysis, which is published by Oxford University Press and is one of the authoritative journals in the field of kidney transplantation. The reference is Nephrol Dial Transplant (2012) 27: 41–50.
The safety assessment of kidney donors is mainly divided into three aspects: perioperative, short-term and long-term.
First, let’s look at perioperative safety. In the 1970s, the perioperative mortality rate of relatives of kidney donors was 0.1%, in the 1980s it was 0.04%, and at the end of the 20th century it was as low as 0.01-0.03%. This risk value is already very small, after all, living donor nephrectomy is also a major operation.
Next, let’s look at short-term risks. Here are a dozen studies published over the past four or five decades. From early studies, the short-term postoperative glomerular filtration rate (this is the gold standard for kidney function, creatinine is not) is roughly 65-70% of the preoperative level. Theoretically, after removing one kidney, only half of the kidney function should be left, so why is there still about 2/3 of kidney function? This is where the human body is strong, and each organ has its own reserve function. After losing a kidney, the remaining kidney will use its reserve function, just like calling up the reserve to go to the battlefield. Therefore, the actual remaining kidney function is not only 50% of the original.
Some people may say that these are data from half a century ago, so let’s take a look at the current data.
The numbers are similar, which shows that the level of surgeons half a century ago was also very high.
After looking at the short-term prognosis, let’s take a look at the impact on long-term physical health. Foreign scholars have done a lot of research, covering Asians, North Americans, Europeans and other races. In terms of mortality, there is no obvious difference between kidney donors and the general social population. A recent Norwegian study included kidney donors from 1963 to 2007, and even found that the mortality rate of living kidney donors was even lower than that of the general population in terms of cardiovascular death.Will long-term renal function decrease? In fact, the glomerular filtration rate itself decreases with age. Several studies with a follow-up of 15-20 years showed that the glomerular filtration rate was about 66-85% of the preoperative level. Another study with an average follow-up of 25 years found that the glomerular filtration rate was as high as 72% before the operation. Overall, donating a kidney has almost no effect on the renal function of long-term kidney donors.
The risk of a donor developing uremia after donating a kidney is 180 people/million people/year, while the incidence of uremia in the general population is 268 people/million people/year. In fact, the incidence of uremia in donors is lower than that in the general population.
Finally, let’s summarize. It is safe for living relatives to donate kidneys if they meet the conditions. Whether in the early or late stages after surgery, it has no significant effect on the kidney function of the donor, and this safety is based on strict preoperative screening and evaluation.
After donating a kidney, the donor should undergo regular physical examinations. It is precisely because of the importance attached to the donor himself that in real life, the frequency of physical examinations will be higher, which is conducive to the early detection of various diseases, and then early treatment can be found if problems are found. Therefore, as long as the living relative kidney transplant is performed in accordance with the regulations, it is still very safe for the donor.
Text | Yang Cheng Illustration | Lily
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