Arteriosclerosis in Kidneys from Healthy Live Donors: Comparison of Wedge and Needle Core Perioperative Biopsies (Report)

Arteriosclerosis in Kidneys from Healthy Live Donors: Comparison of Wedge and Needle Core Perioperative Biopsies (Report)

With the number of available deceased donor kidneys being insufficient to meet the transplantation needs of an increasing end-stage renal disease (ESRD) population, the popularity of live donor renal transplantation has risen dramatically during the past 2 decades. (1,2) The trend toward live donor kidney transplantation has also been supported by data indicating superior survival rates for grafts from live compared with deceased donors, (3) as well as the excellent results now obtained in highly sensitized patients who can undergo preoperative desensitization as needed to reduce titers of donor-specific antibodies to levels safe for live donor transplantation. (4-6) Short- and long-term risks to live kidney donors have been shown to be quite low in multiple studies, (7-18) and use of laparoscopic donor nephrectomy has markedly reduced perioperative morbidity. (19,20) Still, it remains unknown whether there may be a subset of live kidney donors that is at increased risk for ESRD or other long-term complications. Ellison et al (21) reported that 56 live kidney donors had been listed for deceased donor kidney transplants as of February 2002, although the rate of ESRD among kidney donors from 1987 until February 2002 was only 0.04%, barely exceeding the 1999 adjusted incident rate for ESRD in the general US population (0.03%).21 The most common cause of ESRD among live kidney donors was hypertensive nephrosclerosis, accounting for 20 (39%) of the 51 cases in which a cause was known. (21) In this regard, it is also noteworthy that a recent meta-analysis of 48 studies comprising a total of 5145 live kidney donors concluded that the risk of developing hypertension within 5 to 10 years after kidney donation does exceed the risk anticipated from aging alone. (15)

Arteriosclerosis in Kidneys from Healthy Live Donors: Comparison of Wedge and Needle Core Perioperative Biopsies (Report)

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