생체 신장 제공자의 수술 후 장기 추적 결과

Background: Kidney donation is a relatively safe procedure with minimal adverse effects. But some reports have described the development of proteinuria and hypertension in donors after nephrectomy. There have been a number of non-Korean studies which conclude that the procedure is relatively safe and a good quality of life is expected for living donors after kidney transplantation, but not enough of these studies have been published in Korea. We evaluated the physiologic and psychosocial impacts after kidney donation in this study. Methods: Between April 1988 and April 2010, we performed 201 living donor nephrectomies and obtained information for 88 (43.7%) of the donors. We measured their estimated glomerular filtration rate (GFR), blood pressure, body mass index, hemoglobin and cholesterol level, and assessed the prevalence of hypertension and proteinuria in this group. These donors completed a questionnaire regarding their health status and psychosocial outcomes after donation. Results: The average time of the donor assessment after nephrectomy was 95.05±85.45 months (range, 6∼261). The left kidney was used in 76 patients (86%). There was a total complication rate of 8%, but no serious complications were observed. Proteinuria was found in 9 patients (10%) and hypertension in 11 patients (11%). GFR decreased from 103.65±25.02 mL/min to 76.12±19.90 mL/min ( P＜0.001) and hemoglobin decreased from 13.91±1.62 g/dL to 13.01±1.72 g/dL ( P＜0.001). Five patients (6%) developed a post-donation GFR between 40 and 60 mL/min, with 2 patients being observed to have a post-donation GFR below 20 mL/min. In the questionnaire responses, most donors did not report problems affecting routine life or any economic impact. Their donation satisfaction results were very high (92%). Conclusions: Living kidney donors were observed to result in reduced GFR after nephrectomy. Follow-up visits with living kidney donors is essential in order to monitor risk factors related to the deterioration of their residual kidney function.