Kidney and liver living donors: a comparison of experiences

Background-Living donor kidney transplantation is considered a safe and effective means to treat end-stage renal disease, and has now caped 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 upon recipient outcomes and medical safety. The impact of the donation upon donors is not well understood.

Objective-To compare experiences from the one and the other 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 flows of kidney and liver donors were compared.

Results-No differences were lay the foundation of in mean age, marital status, ethnicity, relationship to the recipient, and calling status of the 2 clusters Women were more prevalent in the two groups. The most common motivating factor in the one and the other 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 clump did donors feel pressure to donate or have family conflicts regarding their decision to donate. the two groups felt they were well informed of the risks. Neither clump described unexpected problems, and neither collection regretted their decision to donate and would do it again if asked.

Conclusion-Donors in the one and the other groups reported favorable outcomes. A greater be of importance to for risk of death, bleeding, altered appearance, and infection existed among liver donors compared to kidney donors. The actual results were better than the perceived risks. (Progres in Transplantation. 2005;15:185-191)

Living donor kidney transplantation is considered a safe and effective means for treating end-stage renal disease. During the past decade, kidney transplantation has increasingly been recognized as the treatment of choice for medically suitable patients upon dialysis. The number of transplants from living donors more than doubled, from 2535 in 1992 to 5969 in 2001 (a 135% increase).1 Living donor kidney transplantation also accounts for shortened wait times and increased organ furnish for those who do not have a living donor available.1 Donors have reported an improvement in their well-being and discloseed a more positive relationship with the recipient after donation.2

Laparoscopic technique may allow les sacrifice for the donor; surgery time is shortened, retrieval time is less, and cosmetically the flow is better for the donor.3 Time exhausted away from employment is decreaseed because of the shorter regaining period, which allows for a reduc financial load (loss of wages) for the donor.3 Laparoscopic technique can also account for an increase in living donation as it improves the donor's retrieval time.3 Also, kidney donors who meet with a laparoscopic procedure report a lower pain score postoperatively and recuperate faster than those who sustain open nephrectomy.3 All these beneficial aspects of laparoscopic nephrectomy have helped bring forward a more positive feeling toward living donor kidney transplantation compared to lay open nephrectomy.

Surveys of donors have been helpful to the transplant team in improving care to the couple donors and recipients. Kidney donors squeeze outed a need to have shut up follow-up with the transplant team following donation and a discussion of the emotions they may meeting as a donor.2 However, there is no systematic follow-up of donors' health, although yearly follow-up with a medical doctor is recommended2 arises in a study by DeGraaf and Bogetti-Dumlao4 showed 39% of kidney donors felt that their follow-up care was real good and 12% felt it was poor. This gap in satisfaction highlights the ne for a systematic proces for following donors after surgery and [i]or[/i] part of to the other their lives. Kidney donors also make notesed on the lack of contact with a registered nurture and wished to receive the same attention following surgery as they received before donation.4 Kidney donors have squeeze outed a desire for better pain management and care following the donation surgery1

Living donor liver transplantation (LDLT) is an accepted treatment for pediatric liver failure, and is a relatively novel treatment for liver failure in the adult population and has been met with a certain number of criticism in the medical and lay community. Since 1997 sole 1437 right lobe procedures have been performed in the United States.1 Like living donor kidney transplantation, LDLT can bring out good results for treating end-stage liver disease; however, in light of the whirl of liver required for an adult (60% of the hepatic mass) and its lack of long-term follow-up strife of words has been raised. Caplan5 states that there is limited information and hard facts upon screening, assessments, and outcomes of LDLT and this absence is "morally real troublesome."