Kidney and Liver Living Donors: A Comparison of Experiences

Abstract

Background

Living donor kidney transplantation is considered a safe and effective means to treat end-stage renal disease, and has now exceeded the number of deceased donor kidney transplantations performed annually. Living donor liver transplantation is more controversial and has received criticism in the medical and lay community. Studies focus on recipient outcomes and medical safety. The impact of the donation on donors is not well understood.

Objective

To compare experiences from both kidney and liver living donors, including their motivation, perceived risks, and postoperative experience.

Methods

Questionnaires about the donation experience were mailed to 70 patients who underwent laparoscopic donor nephrectomy and 85 patients who underwent hepatectomy at a large academic medical center. Results of kidney and liver donors were compared.

Results

No differences were found in mean age, marital status, ethnicity, relationship to the recipient, and employment status of the 2 groups. Women were more prevalent in both groups. The most common motivating factor in both kidney and liver donors was “because it was family,” 81% and 82%, respectively. Kidney donors describe the decision to donate as easy compared to the liver donors (P=.049). In neither group did donors feel pressure to donate or have family conflicts regarding their decision to donate. Both groups felt they were well informed of the risks. Neither group described unexpected problems, and neither group regretted their decision to donate and would do it again if asked.

Conclusion

Donors in both groups reported favorable outcomes. A greater concern for risk of death, bleeding, altered appearance, and infection existed among liver donors compared to kidney donors. The actual outcomes were better than the perceived risks.

Get full access to this article

View all access options for this article.

References

United Network for Organ Sharing . Available at: http://www.unos.org. Accessed April 30, 2004.

Johnson

Anderson

Jacobs

. Long-term follow up of living kidney donors: Quality of life after donation. Transplantation. 1999;67:717–721.

Steinhauser

Dawson

Barshick

Janecek

. Pain experienced by laparoscopic donor nephrectomy patients in an academic medical setting. Prog Transplant. 2003;13:117–121.

De Graaf Olson

Bogetti-Dumlao

. Living donors' perception of their quality of health after donation. Prog Transplant. 2001;11:108–115.

Caplan

. Proceed with caution: Live living donation of lobes of liver for transplantation. Liver Transplant. 2001;7:494–496.

Diaz

Renz

Mudge

. Donor health assessment after living-donor liver transplantation. Ann Surg. July 2002;236:120–126.

Beavers

Sandler

Fair

Johnson

Shrestha

. The living donor experience: Donor health assessment and outcomes after living donor liver transplantation. Liver Transplant. 2001;7:943–947.

Trotter

Talamantes

McClure

. Right hepatic lobe donation for living donor liver transplantation: Impact on donor quality of life. Liver Transplant. 2001;7:485–493.

Hunt

Chandra

Smith

Rudow

LaPointe D

Emond

Brown

. Predictors of living liver donation: Faith, education and close relationship to the recipient. Am J Transplant. 2003;3(suppl 5):374.

10.

Brown

Russo

Lai

. A survey of liver transplantation from living adult donors in the United States. N Engl J Med. 2003;348:818–825.

11.

New York State Committee on Quality Improvement in Living Liver Donation . A report to New York State Transplant Council and New York State Department of Health; December 2002. Available at: http://www.health.state.ny.us. Accessed April 13, 2005.

12.

Schiffman

Brown

Olthoff

. Living donor liver transplantation: Summary of a conference at the National Institute of Health. Liver Transplant. 2002;8:174–188.

13.

Burroughs

Waterman

Hong

. One organ donation, three perspectives: Experiences of donors, recipients, and third parties with living donation. Prog Transplant. 2003;13:142–150.