Login to Access Video or Poster Abstract: MP06-01
Sources of Funding: None

Introduction

In 2014, approximately 6,100 people in the United States underwent living donor nephrectomy. Unlike other types of organ donation, this patient population has a longer-than-average life expectancy due to strict selection criteria. Greater than 99% of patients that donated a kidney at Cedars-Sinai Medical Center donated to an immediate family member, relative, or close friend. Our study seeks to qualify and quantify functional changes in the relationship between the donor and the recipient before and after surgery as well as to identify perioperative complications and stress to determine if patients are content with their decision to donate.

Methods

From 2002-2012, 532 patients underwent donor nephrectomy for kidney transplant at Cedars-Sinai Medical Center. After IRB approval, a randomized subset of these patients were administered a standardized questionnaire regarding his or her experience. We assessed if each patient would undergo the donation process again, now having more intimate knowledge and appreciation of the pre- and post-operative surgical and medical course.

Results

Of the fifty patients who participated in our survey, 92% stated that their relationship with the recipient improved after surgery. Of the 8% that noted a deterioration in the relationship, there was a distribution of dissatisfaction with relation to the sexual relationship (n=1), recipient personality changes (n=1), or divorce (n=2). Approximately 10% of patients experienced a complication related to surgery, all of which were clavian grade I-II. Examples of these included incisional hernia (n=3, upper midline incision, BMI>30 kg/m2) and urinary tract infection (n=2). Overall, 98% of patients were extremely satisfied with the donation process and would not hesitate to participate again. Only one patient stated that he would not donate again, as he developed an unanticipated glomerulonephropathy not related to surgery that required hemodialysis.

Conclusions

Our research demonstrates that the act of donating a kidney overwhelmingly enhances the bond between the donor and recipient. Even donors who noted a decline in their relationship with the recipient all stated that they would still donate if faced with the same decision again. This suggests that the relationship with the recipient is of highest importance and a crucial component of pre-operative counseling that should be emphasized. Our urology group has started to incorporate this practice in our management with great success.

Funding

None