People who donate a kidney voluntarily face a lower risk of death from the operation than doctors have long thought, a team of researchers announced.
The study tracked living kidney donations over 30 years and found that by 2022, fewer than 1 in 10,000 donors had died within three months of surgery. Transplant centers have been using older data that cited a risk of 3 deaths per 10,000 living donors. when counseling donors about potentially life-threatening surgical complications.
“Over the past decade, the operating room has become much safer for living donors,” said Dr. Dorry Segev, a transplant surgeon at NYU Langone Health and co-author of the study published in JAMA.
This has been made possible largely by more modern surgical techniques, Segev said, calling for guidelines to be updated to reflect these safety improvements and perhaps increase interest in living donation.
Transplant recipients are often more concerned about potential risks to their donors than the potential donors themselves.
“It is even more reassuring for them to allow their friends or family to donate to them,” Segev said.
Thousands of people die each year waiting for an organ transplant. Living donors can donate one of their two kidneys or part of their liver, the only organ that regenerates.
With nearly 90,000 people on the waiting list for a kidney transplant in the United States, find a living donor Not only does it reduce the number of years of waiting, but these organs usually survive longer than those from deceased donors.
However, in 2023, only 6,290 of the more than 27,000 kidney transplants in the United States came from living donors, the lowest number since before the pandemic. But safety is not the only obstacle to living donation. So is awareness, as many patients are reluctant to ask about this option And although the recipient’s medical insurance covers the expenses, some donors have to face expenses such as travel or loss of wages during the recovery period.
The NYU team analyzed U.S. records of more than 164,000 kidney donations from 1993 to 2022 and found 36 post-surgical deaths. The donors at highest risk were men and those with a history of high blood pressure.
Only five of those deaths have occurred since 2013. That period coincided with U.S. transplant centers shifting to minimally invasive kidney removal and adopting a better way to stop bleeding from the renal artery, Segev said.
It’s a safe operation that has become even safer over time,” which is important for potential donors to know, said Dr. Amit Tevar of the University of Pittsburgh Medical Center, who was not involved in the study.
But there are also long-term risks to consider, he stressed, including whether the donor’s remaining kidney is expected to last the rest of his or her life.
The risk that a donor will later develop kidney failure is also small and depends on factors such as obesity, high blood pressure, smoking, and family history of kidney disease. Calculating the risk helps doctors determine the likelihood that a donor will be a donor. a potential donor have problems later, and transplant centers may have slightly different eligibility criteria.
There is no such thing as a moderate-risk or high-risk donor: either you are suitable or you are not,” Tevar said of the decision to accept or reject a potential donor.
Doctors used to think that young adults were ideal living donors. But Segev says older living donors are now preferred if they won’t outlive their remaining kidney.
If a living donor later suffers from kidney failure, he or she will have priority for the transplant.
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