Kidney donors — long-term follow-up

Improved methods in the management of recipients and the development of new of immunosuppressive protocols has brought wide acceptance of renal transplantation as the method of choice in the treatment of patients with chronic renal failure. In North America and Europe, cadaver donors are the major source of kidneys and other organs for transplantation (1). However, in Kuwait and other developing countries, cadaveric organ procurement is still in its infancy and living donors are the main source of kidneys for transplantation. Even in countries where cadaveric organ procurement is well developed, there is still a shortage of organs because demand exceeds the supply. This is partly met by using kidneys from living donors. In 1984, 32% of kidney transplantations in the U.S.A. were from living donors (2). In our Center, over the last 11 years, living donors form 80% of the source of kidneys for transplantation. Although renal transplantation has gained wide acceptance, kidney transplantation from living donors is being discussed with regard to moral, ethical and medical aspects in view of possible long-term complications such as proteinuria and hypertension (3, 4). In order to examine these adverse but largely theoretical long-term problems, we have followed up and studied in detail the long-term functional, psychological and social effects of nephrectomy on kidney donors who had donated a kidney to a living related recipient 5–10 years previously.