Early Complications in Kidney Donors and Course of Health-related Quality of Life 12 mo After Donation: An Analysis of the Swiss Organ Living-Donor Health Registry

Charlotte Brügger; Zoé Hunkeler; Matthias Diebold; Joana Krättli; Irene Geiger; Caroline Wehmeier; Thomas Wolff; Bruno Vogt; Federico Storni; Dela Golshayan; Tobias Zingg; Sophie de Seigneux; Fadi Haidar; Isabelle Binet; Aurelia Schnyder; Kerstin Hübel; Thomas Müller; Fabian Rössler; Jürg Steiger; Patricia Hirt-Minkowski

doi:10.1097/TXD.0000000000001716

Early Complications in Kidney Donors and Course of Health-related Quality of Life 12 mo After Donation: An Analysis of the Swiss Organ Living-Donor Health Registry

Transplant Direct. 2024 Oct 10;10(11):e1716. doi: 10.1097/TXD.0000000000001716. eCollection 2024 Nov.

Authors

Charlotte Brügger¹, Zoé Hunkeler¹, Matthias Diebold¹, Joana Krättli², Irene Geiger², Caroline Wehmeier¹, Thomas Wolff³, Bruno Vogt⁴, Federico Storni⁵, Dela Golshayan⁶, Tobias Zingg⁷, Sophie de Seigneux⁸, Fadi Haidar⁸, Isabelle Binet⁹, Aurelia Schnyder⁹, Kerstin Hübel^{10

11}, Thomas Müller¹⁰, Fabian Rössler¹¹, Jürg Steiger^{1

2}, Patricia Hirt-Minkowski^{1

2}

Affiliations

¹ Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Basel, Switzerland.
² Swiss Organ Living-Donor Health Registry (SOL-DHR), University Hospital Basel, Basel, Switzerland.
³ Vascular Surgery and Organ Transplantation Clinic, University Hospital Basel, Basel, Switzerland.
⁴ Department for Nephrology and Hypertension, University Hospital Insel, Berne, Switzerland.
⁵ University Clinic for Visceral Surgery and Medicine, University Hospital Insel, Berne, Switzerland.
⁶ Transplantation Center, Department for Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
⁷ Department of Visceral and Transplant Surgery, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
⁸ Nephrology and Hypertension Division, University Hospital Geneva (HUG), Geneva, Switzerland.
⁹ Clinic for Nephrology and Transplantation Medicine, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
¹⁰ Division of Nephrology, University Hospital Zurich, Zurich, Switzerland.
¹¹ Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.

Abstract

Background: Since 1998, the Swiss Organ Living-Donor Health Registry (SOL-DHR) has recorded peri- and postoperative complications of living kidney (LK) donors, as reported by all Swiss transplant centers and has collected follow-up data prospectively.

Methods: We analyzed the early complications of 2379 consecutive individuals who donated a kidney between January 1998 and June 2022 and assessed their health-related quality of life (HRQoL) 1 y after donation.

Results: In total, 447 early complications in 404/2379 LK donors (17.0%) were reported to the SOL-DHR. The frequency of donors with major complications (ie, Dindo-Clavien classification 3/4) was 2.4%. In total, 31 donors needed reoperation, and in 13/31 (42%), donors reoperation was necessary because of bleeding complications. Independent risk factors for major early complications were older donor age (P = 0.005) and type of surgical approach (ie, the laparoscopic retroperitoneal compared with laparoscopic transabdominal surgery; P = 0.01), but not sex. We observed a U-shaped association of body mass index, where very low/high body mass indexes had higher odds of major early complications, without reaching statistical significance. Although HRQoL was affected by kidney donation, 96.5% of donors indicated that they would donate their kidney again. The only independent risk factor for low HRQoL based on mental health scores was worsening EB after living kidney donation (P < 0.0001).

Conclusions: Overall, living kidney donation is a safe procedure, however, donor age and type of surgical approach affect the risk of complications. A decline in emotional bonding with the recipient after donation may worsen the quality of life of the donor.