Long-term Follow-up of Living Kidney Donors

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1 : 12 2 Vol. 12, No. 2, November, ,2 2 1,2 1 1,2 1,2 = Abstract = Long-term Follow-up of Living Kidney Donors Jang Il Moon, M.D.1,2, Sung Do Kim, M.D.2, Soon Il Kim, M.D.1,2 Soo Hyeon Kim, R.N.1, Yu Seun Kim, M.D.1,2 and Kiil Park, M.D.1,2 1Institute for Transplantation Research and 2Department of Surgery Yonsei University College of Medicine Kidney transplantation using living donors has been performed in our hospital since the very start in In recent years, we have expanded living donor pool, including unrelated one, because the number of cadaveric donors is insufficient. A very important issue in living kidney donor transplantation is whether the donation is safe or not for the donor. The aim of this study was to examine the long-term impact of uninephrectomy on the renal function, blood pressure, and proteinuria in living kidney donors. We could followed 59 donors who had donated a kidney more than 10 years ago. Among these 59 donors, 19 donors visited hospital and were undertaken physical examination and laboratory evaluation. We checked blood pressure, BUN/creatinine, 24 hours urine protein, and creatinine clearance to these donors. The rest 40 donors were traced by telephone survey for medical history and survival. The mean duration of follow-up were and years, respectively in both group of the donors. The mean age at last follow-up were and years old, respectively. Actually 2 patients proved to have well controlled hypertension with anti-hypertensive medications. Mean values of systolic and diastolic blood pressure were and mmhg in 19 donors, which showed no difference from general population compared with nationwide survey of blood pressure. There were no difference of BUN/creatinine, 24 hours urine protein, and creatinine clearance between pre-nephrectomy and follow-up values. There was one patient death in the telephone surveyed group, who died of stomach cancer. No body had specific medical illness and took hypertensive medication in the telephone surveyed group. We could not demonstrate any deterioration of renal function and development of uninephrectomy induced hypertension in living kidney donor more than 10 years after kidney donation. Key Words: Kidney transplantation, Living donor, Long-term outcome *

2 ,,,,.. 10, ,, ,,,,,, ,, , Journal of Hypertension.1) Table * , 40. 8, mmhg, mmhg. 24 BUN mg/dl, creatinine mg/dl mg/day, ml/min/bsa. 2 69, mmhg, 7490 mmhg. 19, , (n=19) (n=40) (/) 8/11 19/ * 10

3 5 231 Table Sex Korean National survey1 Uninephrectomy donor(n=19) Age SBP2 DBP3 n SBP DBP Male Female Korean National Survey1; Jones DW, Kim JS, Andrew ME: Body mass index and blood pressure in Korean men and women: the Korean National Blood Pressure Survey. J Hypertens 12: , 1994 SBP2; systolic blood pressure(mmhg, mean standard deviation) DBP3; diastolic blood pressure(mmhg, mean standard deviation) Table (n=19) Pre-transplant Post-transplant day 7 Follow-up SBP1(mmHg) DBP2(mmHg) BUN(mg/dl) creatinine(mg/dl) Ccr3(ml/min/BSA) preteinuria(mg/day) SBP1; systolic blood pressure, DBP2; diastolic blood pressure, Ccr3; creatinine clearance , %.2)....

4 ) Fehrman-Ekholm,.4,5).6). Najarian %.6).,,.7,8), %.9) (hyperfiltration injury). Eberhard ). Narkin-Burgess 45.11) BUN/Cr, 24.. REFERENCES 1) Jones DW, Kim JS, Andrew ME, Kim SJ, Hong YP: Body mass index and blood pressure in Korean men and women: the Korean National Blood Pressure Survey. J Hypertension 12: 1433, ) : ) Jones KW, Peters TG, Charlton RK, Lenz BJ, Walker GW, Repper S, Crews MJ, Antonucci LE, Peters EJ: Current issues in living donor nephrectomy. Clin Transplant 11: 505, ) Fehrman-Ekholm I, Johansson A, Konberg A, Tyden G: Long-term survival of living related kidney donors. Transplant Proc 29: 1481, ) Fehrman-Ekholm I, Elinder CG, Stenbeck M, Tyden G, Groth CG: Kidney donors live longer. Transplantation 64: 976, ) Najarian JS, Chavers BM, McHugh LE, Matas AJ: 20 years or more of follow-up of living kidney donors. Lancet 340: 807, ) Johnson EM, Remucal MJ, Gillingham KJ, Dahms RA, Najarian JS, Matas AJ: Complications and risks of living donor nephrectomy. Transplantation 64:

5 , ) Shaffer D, Sahyoun AI, Mandras PN, Monaco AP: Two hundred one consecutive living-donor nephrectomies. Arch Surg 133: 426, ) Anderson RG, Beuschen AJ, Lloyd LK, Dubovsky EV, Burns JR: Short-term and long-term changes in renal function after donor nephrectomy. J Urol 145: 11, ) Eberhard OK, Kliem V, Offner G, Oldhafer K, Fangmann J, Pichlmay R, Koch KM, brunkhorst R: Assessment of long-term risks for living related kidney donors by 24-h blood pressure monitoring and testing for microalbuminuria. Clin Transplant 11: 415, ) Narkun-Burgess DM, Nolan CR, Norman JE, Page WF, Miller PL, Meyer TW: Forty-five year follow-up after uninephrectomy. Kidney Intl 43: 1110, 1993

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