Technology has come a long way.
Recent research has found that the risk of death from kidney donation is significantly lower than previously thought. An extensive study tracking living kidney donations over 30 years revealed that by 2022, fewer than one in 10,000 donors died within three months of the surgery. This is a substantial improvement from earlier estimates, which suggested a risk of three deaths per 10,000 donors. The findings highlight how advancements in surgical techniques over the past decade have contributed to increased safety for donors.
Dr. Dorry Segev of NYU Langone Health, who co-authored the study published in JAMA, attributed the decreased risk to innovations in minimally invasive surgical methods and improved techniques for managing renal artery bleeding. Segev emphasized the need for updated guidelines to reflect these safety improvements, which could encourage more people to consider living donation. He noted that potential donors are often reassured by these safety advances, which could also alleviate concerns for transplant recipients who worry about the risks to their donors.
The study analyzed over 164,000 U.S. kidney donations from 1993 to 2022 and found that most post-surgical deaths occurred among male donors and those with high blood pressure. The majority of these deaths happened before 2013, a period before significant improvements in surgical practices. Since then, the adoption of minimally invasive techniques has markedly reduced the mortality rate.
Despite these improvements, living donation remains underutilized. In the past year, only 6,290 out of more than 27,000 kidney transplants in the U.S. came from living donors. This reflects not only ongoing concerns about safety but also challenges such as raising awareness and addressing the financial burdens faced by donors, such as travel and lost wages.
Long-term risks also need consideration, including the potential for kidney failure in donors, influenced by factors like obesity and high blood pressure. Risk calculators and varying eligibility criteria help assess donor suitability. Additionally, older individuals are now increasingly seen as suitable donors due to more accurate predictions of the longevity of their remaining kidney. If a donor experiences kidney failure later, they are given priority for a transplant.
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