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

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...

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Main Authors: 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
Format: Article
Language:English
Published: Wolters Kluwer 2024-11-01
Series:Transplantation Direct
Online Access:http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001716
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author 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
author_facet 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
author_sort Charlotte Brügger, MS
collection DOAJ
description 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.
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spelling doaj-art-dd6c2f52198a4211bacc9011c89cad7d2024-11-26T08:06:28ZengWolters KluwerTransplantation Direct2373-87312024-11-011011e171610.1097/TXD.0000000000001716202411000-00005Early 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 RegistryCharlotte Brügger, MS0Zoé Hunkeler, MS1Matthias Diebold, MD2Joana Krättli, MD3Irene Geiger, Lic Phil4Caroline Wehmeier, MD5Thomas Wolff, MD6Bruno Vogt, MD7Federico Storni, MD8Dela Golshayan, MD, PhD9Tobias Zingg, MD10Sophie de Seigneux, MD11Fadi Haidar, MD12Isabelle Binet, MD13Aurelia Schnyder, MD14Kerstin Hübel, MD15Thomas Müller, MD16Fabian Rössler, MD17Jürg Steiger, MD18Patricia Hirt-Minkowski, MD191 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.2 Swiss Organ Living-Donor Health Registry (SOL-DHR), University Hospital Basel, Basel, Switzerland.2 Swiss Organ Living-Donor Health Registry (SOL-DHR), University Hospital Basel, Basel, Switzerland.1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.3 Vascular Surgery and Organ Transplantation Clinic, University Hospital Basel, Basel, Switzerland.4 Department for Nephrology and Hypertension, University Hospital Insel, Berne, Switzerland.5 University Clinic for Visceral Surgery and Medicine, University Hospital Insel, Berne, Switzerland.6 Transplantation Center, Department for Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.7 Department of Visceral and Transplant Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.8 Nephrology and Hypertension Division, University Hospital Geneva (HUG), Geneva, Switzerland.8 Nephrology and Hypertension Division, University Hospital Geneva (HUG), Geneva, Switzerland.9 Clinic for Nephrology and Transplantation Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.9 Clinic for Nephrology and Transplantation Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.10 Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.10 Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.11 Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.1 Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.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.http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001716
spellingShingle 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
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
Transplantation Direct
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
url http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001716
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