DONOR EVALUATION AND ALLOCATION
Are We Taking Proper Care of Living Donors? A Follow-up Study of
Living Kidney Donors in Poland and Further Management Proposal
W. Rowinski, A. Chmura, Z. Wlodarczyk, M. Ostrowski, B. Rutkowski, P. Domagala, K. Dziewanowski,
J. Matych, M. Durlik, and R. Grenda
ABSTRACT
Objective. The first kidney transplantation was performed in Poland in 1966. Since that
time approximately 11,000 patients have undergone the procedure, but most of them have
received the kidney from deceased donors; only 342 procedures utilized living donors (LD;
2.7%). The aim of this study was to review the results of a LD follow-up in Poland.
Patients and Methods. A questionnaire was sent to 11 centers that had performed 197
LD kidney transplantations during the last 10 years. The donors, who were all genetically
or emotionally related, were 23 to 61 years old. No donor showed an abnormality regarding
cardiovascular function or metabolic abnormalities.
Results. The 6 centers that responded reported data on 118 donors. In 2 centers no
donor follow-up was available. Eleven of 118 donors did not attend the control visits.
Follow-up of the remaining donors ranged from 2 to 8 years. Four donors died at 4 to 5
years after nephrectomy due to cerebral hemorrhage, brain tumor, stomach cancer, or car
accident. The overall mean serum creatinine had increased from 0.8 to 1.25 mg/dL, but 2
patients displayed a value 2 mg/dL. The calculated creatinine clearance (MDRD formula)
had decreased from 95 to 65 mL/min (P .05). In 3 donors proteinuria (0.6 g/24 h) was
observed at 3 to 5 years after donation. Of 3 patients who experienced mild hypertension, 2
required treatment. The remaining donors showed normal blood pressures.
Conclusions. Since 2007, when the Living Donor Registry was introduced by law, transplant
centers have been obliged to report data on each LD procedure together with follow-up data.
All donors are life-insured (by Alianz SA) for 3 months from the time of transplantation.
Stepwise interventional reno- and cardioprotection programs have been introduced after
nephrectomy for LD, especially those with metabolic abnormalities at the time of donation.
O
RGAN TRANSPLANTATION has become an efficient
life-saving procedure. Organ replacement from either a
living or a deceased donor is preferred to chronic dialysis
therapy, because transplantation provides a better quality of
life and longer patient survival. Due to a number of specific
barriers, the availability of deceased donors has displayed a
low, stable plateau, which is the reason that 10% to 15% of
patients who have been accepted for transplantation die on
waiting lists. The shortage of organs for transplantation is a
worldwide problem, which limits access for thousands of patients.
From the Department of Medical Sciences (W.R.), University of
Warmia, Olsztyn, Poland; Medical University Warsaw (Z.W., A.C., P.D.,
M.D.), Medical University, Bydgoszcz, Poland; Medical University
(M.O.), Szczecin; Medical University (B.R.), Gdansk, Poland; Vojevod-
ship Hospital (K.D.), Szczecin, Poland; Medical University (J.M.), Lódz ´;
Children’s Memorial Health Institute (R.G.), Warsaw, Poland.
Address reprint requests to Wojciech Rowinski, MD, PhD, Trans-
plantation Institute, Warsaw Medical School, ul. Nowogrodzka 59,
Warsaw 02-006, Poland.
© 2009 by Elsevier Inc. All rights reserved. 0041-1345/09/$–see front matter
360 Park Avenue South, New York, NY 10010-1710 doi:10.1016/j.transproceed.2008.08.140
Transplantation Proceedings, 41, 79 – 81 (2009) 79