Koch Martina, Wegner Jeannine, Bormann Eike, Kröncke Sylvia, Riepenhausen Sarah, Neuhaus Philipp, Varghese Julian, Gerß Joachim, Sommerer Claudia, Suwelack Barbara
Department of General, Visceral, and Transplantation Surgery, University Medical Center, Mainz, Germany.
Department of Internal Medicine, Transplant Nephrology, Faculty of Medicine, University of Münster, Muenster, Germany.
Kidney Int Rep. 2025 Jul 2;10(9):3058-3069. doi: 10.1016/j.ekir.2025.06.052. eCollection 2025 Sep.
The German health care system lacks data on surgical complications and self-reported outcomes (SROs) of living donors. The prospective German Living Kidney Donor Registry, SOLKID-GNR aims to improve the assessment of donors' medical and psychosocial risks.
Data were collected before (PRE) and 3 months after (POST) living kidney donation from transplantation centers (TCs) and donors via SROs. We reported perioperative complication rates for different surgical techniques and correlated them with donors' SROs. Datasets of 1020 donors from 30 German TCs were analyzed.
Donor nephrectomy procedures included laparoscopic (57.9%), retroperitoneoscopic (21.4%), open retroperitoneal (16.0%), or open abdominal nephrectomy (4.7%). Perioperative complications reported by TCs ranged from 9.8% (retroperitoneoscopic) to 17.1% (open abdominal), whereas those reported by donors ranged from 12.2% (open retroperitoneal) to 15.0% (open abdominal). Donors were discharged sooner and returned to work earlier after minimally invasive surgery; however, had comparable quality-of-life (QoL) after donation. The physical component summary (PCS) scores of the Short Form-12 (SF-12) were similar between the 4 surgical methods postdonation; however, they were lower in donors with TC- or self-reported complications than in those without. The mental component summary (MCS) scores of the SF-12 were lower in case of self-reported complications only. Despite 12.5% of self-reported complications, 96.4% expressed a willingness to donate again, and 94.1% felt well-informed.
Although the surgical technique does not directly affect donors' QoL shortly after donation, minimally invasive procedures result in shorter hospital stays and a quicker return to work. Self-reported complications have a greater impact on mental QoL than those documented by transplant centers, highlighting the importance of subjective experiences during recovery.
德国医疗保健系统缺乏活体供体手术并发症及自我报告结局（SRO）的数据。德国前瞻性活体肾供体登记处SOLKID-GNR旨在改善对供体医疗和心理社会风险的评估。
通过SRO从移植中心（TC）和供体收集活体肾捐献前（PRE）及捐献后3个月（POST）的数据。我们报告了不同手术技术的围手术期并发症发生率，并将其与供体的SRO相关联。对来自德国30个TC的1020名供体的数据集进行了分析。
供体肾切除术包括腹腔镜手术（57.9%）、后腹腔镜手术（21.4%）、开放式后腹膜手术（16.0%）或开放式腹部肾切除术（4.7%）。TC报告的围手术期并发症发生率从9.8%（后腹腔镜手术）至17.1%（开放式腹部手术）不等，而供体报告的发生率从12.2%（开放式后腹膜手术）至15.0%（开放式腹部手术）不等。微创手术后供体出院更快且更早恢复工作；然而，捐献后生活质量（QoL）相当。捐献后，简短健康调查问卷12项（SF-12）的身体成分总结（PCS）得分在4种手术方法之间相似；然而，有TC报告或自我报告并发症的供体得分低于无并发症的供体。仅在自我报告有并发症的情况下，SF-12的心理成分总结（MCS）得分较低。尽管有12.5%的自我报告并发症，但96.4%的供体表示愿意再次捐献，94.1%的供体认为信息充分。
尽管手术技术在捐献后不久不会直接影响供体的QoL，但微创手术可缩短住院时间并更快恢复工作。自我报告的并发症对心理QoL的影响大于移植中心记录的并发症，突出了恢复过程中主观体验的重要性。
