Janki Shiromani, Klop Karel W J, Dooper Ine M M, Weimar Willem, Ijzermans Jan N M, Kok Niels F M
Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Department of Internal Medicine, Division of Nephrology, Radboud University Medical Center, Nijmegen, The Netherlands.
Transpl Int. 2015 Nov;28(11):1268-75. doi: 10.1111/tri.12589.
Previously reported short-term results after live kidney donation show no negative consequences for the donor. The incidence of new-onset morbidity takes years to emerge, making it highly likely that this will be missed during short-term follow-up. Therefore, evidence on long-term outcome is essential. A 10-year follow-up on renal function, hypertension, quality of life (QOL), fatigue, and survival was performed of a prospective cohort of 100 donors. After a median follow-up time of 10 years, clinical data were available for 97 donors and QOL data for 74 donors. Nine donors died during follow-up of unrelated causes to donation, and one donor was lost to follow-up. There was a significant decrease in kidney function of 12.9 ml/min (P < 0.001) at follow-up. QOL showed significant clinically relevant decreases of 10-year follow-up scores in SF-36 dimensions of physical function (P < 0.001), bodily pain (P = 0.001), and general health (P < 0.001). MFI-20 scores were significantly higher for general fatigue (P < 0.001), physical fatigue (P < 0.001), reduced activity (P = 0.019), and reduced motivation (P = 0.030). New-onset hypertension was present in 25.6% of the donors. Donor outcomes are excellent 10 years post-donation. Kidney function appears stable, and hypertension does not seem to occur more frequently compared to the general population.
先前报道的活体肾捐赠后的短期结果显示，对捐赠者没有负面影响。新发疾病的发生率需要数年时间才会显现，这使得在短期随访中很可能会被遗漏。因此，关于长期结果的证据至关重要。对100名捐赠者的前瞻性队列进行了为期10年的肾功能、高血压、生活质量（QOL）、疲劳和生存率随访。在中位随访时间10年后，97名捐赠者有临床数据，74名捐赠者有生活质量数据。9名捐赠者在随访期间因与捐赠无关的原因死亡，1名捐赠者失访。随访时肾功能显著下降12.9 ml/min（P<0.001）。生活质量显示，在SF-36身体功能维度（P<0.001）、身体疼痛（P=0.001）和总体健康（P<0.001）方面，10年随访评分有显著的临床相关下降。MFI-20评分在一般疲劳（P<0.001）、身体疲劳（P<0.001）、活动减少（P=0.019）和动力下降（P=0.030）方面显著更高。25.6%的捐赠者出现新发高血压。捐赠10年后，捐赠者的结果良好。肾功能似乎稳定，与普通人群相比，高血压的发生频率似乎没有更高。
