Live kidney donors have similar long-term survival rates as non-donor peers, according to a new study published in the March 10 issue of the Journal of the American Medical Association. Each year, an estimated 6,000 healthy people donate kidneys to ailing loved ones or, in some cases, to strangers through large chain donations. Yet previous studies analyzing the potential health risks to donors have been limited in scope, as they solely included donors of one ethnic background or without common health complications such as hypertension. This new research, however, set out to get more definitive answers to the critical ethical question at the heart of organ donation. As the study authors write, “It is incumbent on the transplantation community to show that these lives are not saved at the cost of placing donors at risk for excess perioperative or long-term mortality.”
In this latest study, a team of researchers from the Johns Hopkins University School of Medicine followed more than 80,000 people who donated kidneys between April 1, 1994, and March 31, 2009. During the study period, 25 donors died within three months of the surgery, a death rate of 3.1 per 10,000. (The death rate for people having their kidneys removed for reasons other than donation is 260 per 10,000.) Additionally, researchers say that the true rate may in fact be lower—somewhere between 1.5 to 2.0 per 10,000 donors—because the study period included the stretch of time in which surgeons were transitioning from open to laparoscopic procedures, and may reflect that learning curve.
While undergoing any surgery introduces risk of death, when it comes to longer-term mortality rates, researchers found that organ donors’ survival was comparable to that of non-donors of similar age, background and health characteristics. By one year after surgery, death rates were similar between donors and the comparison group; after a longer time period—after both five years and 12 years—death rates among kidney donors were comparable or even lower than that of the matched group.
While future research about how organ donation impacts the donor’s body systems in the long term is necessary, researchers say that these findings indicate that kidney donation is a relatively safe procedure, and one that should continue to be used for treatment of seriously endangered patients. As the study authors sum up: “Regardless of what physiologic changes might occur in a healthy adult after kidney donation, our findings of similar long-term survival between donors and healthy comparison patients suggest that these physiologic changes do not result in premature death.”