There’s No Increased Long-Term Risk in Donating a Kidney

Everyone knows about the difficulty patients have in finding a suitable match for a donor kidney.  The use of live healthy donor kidneys has eased the situation somewhat, but the number of such donors is obviously lessened by anxiety about the risks they run – not only the immediate risk of the surgical removal, but possible long-term risks.   A study published in the Journal of the American Medical Association should remove much of this anxiety.  It was designed to compare long-term death rates between donors and non-donors, and to estimate short-term operative risk to the live donors.

Over 80,000 live donors in a US registry between 1994 and 2009 were followed up for an average of 6.3 years.  Their information was compared with that from a collective of 9,300 participants in the NHANES III Study (the National Health and Nutritional Examination Survey).  The focus was on surgical mortality and long-term survival.

Not surprisingly, 90-day mortality was significantly higher in the donors than in the controls – 3.1 per 10,000 vs. 0.4 per 10,000 in the NHANES group.  But this was entirely different by the end of the first year.  Rates were 6.5 per 10,000 for the donors vs. 4.6 per 10,000 for the NHANES group.   

For comparison, the 90-day postoperative mortality was 18 per 10,000 donors for laparoscopic cholecystectomy and 260 per 10,000 for non-donor nephrectomy, so donor nephrectomy is an extremely low-risk procedure. And it’s clear that people who are considering kidney donation can be assured that, beyond this small postoperative mortality risk, there is no excess long-term mortality.