Kidney donation seen as ‘safe and getting safer’
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Key takeaways:
- From 2013 to 2022, the 90-day mortality rate for U.S. kidney donors was 0.9 per 10,000 cases.
- Risk was greater for men and for those with preexisting hypertension.
- Risk was lower with laparoscopic procedures.
The number of U.S. adults who died within 90 days of donating a kidney was less than one per 10,000 donors in the past decade, a significant drop from about three deaths per 10,000 donors from 1993 to 2012, according to study data.
“We have long known kidney donation is safe, but our findings suggest that mortality among donors is rare, and the procedure is safer than ever before,” Macey L. Levan, JD, PhD, associate professor of surgery and population health and director of the Center for Surgical and Transplant Applied Research Qualitative Core at NYU Langone Health and vice president of patient and donor affairs for the Organ Procurement and Transplantation Network, told Healio.
Levan and colleagues compared data on deaths within 90 days of living kidney donation across three time periods: 1993 to 2002, 2003 to 2012 and 2013 to 2022. Data were compiled from the Scientific Registry of Transplant Recipients, the Organ Procurement and Transplantation Network and the National Technical Information Service Limited Access Death Master File.
Results were published in JAMA.
Among 164,593 donations from 1993 to 2022, 36 donors died within 90 days of the procedure — and half of those within 7 days — for a mortality ratio of 2.2 per 10,000 cases. Thirteen deaths occurred from 1993 to 2002 (three per 10,000; 95% CI, 1.6-5.1), 18 from 2003 to 2012 (2.9 per 10,000; 95% CI, 1.7-4.6) and five from 2013 to 2022 (0.9 per 10,000; 95% CI, 0.3-2).
Mortality rates were higher for men than women (four vs. one per 10,000; P .001) and for donors with vs. without preexisting hypertension (7.5 vs. 1.4 per 10,000; P = .03). Rates were similar when assessed by age, race/ethnicity and BMI. Of the 19 cases for which the cause of death was reported, eight were due to hemorrhage, which was the most common cause, according to the researchers. Fewer donors who underwent laparoscopic than open procedures died, but the difference was not statistically significant.
The findings have implications for the transplantation medical community that monitors and quantifies risks, as well as for potential kidney donors and recipients, Levan said.
For donors, “being able to reassure them that this is safe and getting safer is important,” Levan said. “Many people on the kidney waiting list are reluctant to accept a living donor transplant because they are worried about the donor. So, our findings are most reassuring to the potential recipients, that they don’t have to worry about their donor dying from donating to them.”
For more information:
Macey L. Levan, JD, PhD, can be reached at macey.levan@nyulangone.org
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