Thiel G T, Nolte C, Tsinalis D
Universität Basel.
Ther Umsch. 2005 Jul;62(7):449-57. doi: 10.1024/0040-5930.62.7.449.
The Swiss Organ Living Donor Health Registry (SOL-DHR) started in April 1993. The purpose was the prospective and sequential follow up of donors long-term health. Between 1993 and January 2005 737 Living Kidney donations were registered and followed. Two thirds of donors were female and two thirds of recipients male. The three most common relations were life-partners, parents and siblings (approximately 30% each). 10% of donors could not be followed since living far abroad and 5% were lost due to missing current address after moving. 9 donors died (4 malignancies, 2 traffic accidents, 1 myocardial infarction, 1 stroke and 1 suicide), non due to kidney donation. Perioperative complications were age dependent, ranging from 17% in donors below the age of 40 year and 46% in donors older than 70 years. The longterm complications were divided in surgical, medical and psychological ones. The most common surgical long-term complications were pain (cicatrice, back, abdomen) and hernias. The major medical complications were hypertension (35% at seven years after donation) and rising rate of Albuminuria (9% at seven years). Although hypertension was not higher than in an age matched Swiss control population, untreated hypertension was regarded as the higher risk for development of glomerulosclerosis than in people with two kidneys. No donor went into end stage renal failure. Using the SF-8-Test to quantify the psychological well-being the mean MCS (mental component summary) was 54.3 +/- 7.8 as compared to 52.9 +/- 7.7 in the age matched control population. MCS was low (< 40) in 6.2% and very low (< 25) in 2.2% of donors. 94.4 % of donors would donate again, while 4.3% would not (mostly women). The reasons not to donate again was mainly related to poor outcome of the kidney recipient, or long-lasting major pain or disappointment about medical handling before (not enough information, wrong advice) and after organ donation. The association of Swiss Living Organ Donors, where only kidney or liver donors can become a member, are organising self-help-groups for pain, psychological and financial problems (with health insurances). The organisation and financial support of SOL-DHR is briefly described. The waste majority of living kidney donors are very satisfied about the free care given by SOL-DHR.
瑞士活体器官捐赠者健康登记处（SOL-DHR）于1993年4月启动。其目的是对捐赠者的长期健康进行前瞻性和连续性跟踪。1993年至2005年1月期间，登记并跟踪了737例活体肾捐赠。三分之二的捐赠者为女性，三分之二的受者为男性。三种最常见的关系是生活伴侣、父母和兄弟姐妹（各约占30%）。10%的捐赠者因居住在国外而无法跟踪，5%的捐赠者因搬家后现住址缺失而失去联系。9名捐赠者死亡（4例患恶性肿瘤、2例死于交通事故、1例死于心肌梗死、1例死于中风、1例自杀），均非因肾脏捐赠。围手术期并发症与年龄有关，40岁以下捐赠者的发生率为17%，70岁以上捐赠者的发生率为46%。长期并发症分为手术、医疗和心理方面的并发症。最常见的手术长期并发症是疼痛（瘢痕、背部、腹部）和疝气。主要的医疗并发症是高血压（捐赠后7年时为35%）和蛋白尿发生率上升（捐赠后7年时为9%）。尽管高血压发生率并不高于年龄匹配的瑞士对照组人群，但与有两个肾脏的人相比，未经治疗的高血压被认为发生肾小球硬化的风险更高。没有捐赠者进入终末期肾衰竭。使用SF-8测试来量化心理健康状况，平均心理成分总结（MCS）为54.3±7.8，而年龄匹配的对照组人群为52.9±7.7。6.2%的捐赠者MCS较低（<40），2.2%的捐赠者MCS极低（<25）。94.4%的捐赠者愿意再次捐赠，而4.3%的捐赠者不愿意（大多数为女性）。不愿意再次捐赠的主要原因主要与肾移植受者的不良结局、长期的严重疼痛或对器官捐赠前后医疗处理的失望（信息不足、错误建议）有关。瑞士活体器官捐赠者协会（只有肾或肝捐赠者可以成为会员）正在为疼痛、心理和经济问题（与健康保险有关）组织自助小组。简要介绍了SOL-DHR的组织和资金支持情况。绝大多数活体肾捐赠者对SOL-DHR提供的免费护理非常满意。
