ENCOURAGING DONOR SAFETY

 Encouraging Kidney Donation Broadcast: Donating A Kidney is Safer Than Ever 

 

1. Introduction

 We all know that Living Kidney Donors can easily get by with just one functioning kidney, but did you know now there is less than a  1% chance that a Living Donor will die as a result of complications from donating a Kidney for a Kidney Transplant Surgery?

According to a new study from the Journal of American Medical Association, entitled"Thirty-Year Trends in Perioperative Mortality Risk for Living Kidney Donors, " there's reason for anyone involved in a Kidney Transplant situation to be encouraged today! The risks to potential Living Kidney Donors of Death over the last 30 years have been significantly reduced! In fact, the risk of death from donating a kidney is at an all time low!

The study was led by Allan B. Massie, PhD, Department of Surgery, NYU Langone Health, New York City. It was published online on August 28, 2024, in JAMA.

2.  The Study Shows That The Risk of Death For People Who Donate A Kidney Has Dropped By More Than Half 

From 2013 to 2023, the 90 day mortality rate for US Kidney Donors was at 0.9% per 10, 000 Kidney Transplant Surgeries. As we will see, there has never been a safer time in history to give a Kidney. The risk of people who donated a kidney has dropped by more than half according to JAMA's new study! Advances in surgery and medical care, along with careful donor selection have greatly improved the odds.

The Key message here is that  people who volunteer to donate a kidney face even a lower risk of death from the Transplant Operation.

3. The Study Encourages More Donors To Donate.

Each year approximately 6000 Americans voluntarily donate a Kidney according to the Organ Procurement and Transplantation Network.

Based on the data from 1995 through 2009, experts have seen that about 3 out of every 10, 000 Donors were likely to die within 3 months of the Kidney Transplant.

Looking at 30 years worth of the medical records from almost 164, 600 Kidney Donors from across the country, researchers at NYU Langone Health Found that by 2022, less than 1 Death occurred for every 10,000 Kidney Donations or 36 Deaths in 30 years! In other words, it is safer to donate a kidney now than at any other time in history!

The study showed that reviewing 30 years of living kidney donation fewer than 1 of every 10, 000 donors died within 3 months of the surgery. Centers are currently advising potential donors that there are 3 deaths in every  10,000 Living Donor Transplants, and this study has made that obsolete. Now when counseling donors, they can be told in the last decade, it has become a lot safer operation for Kidney Donors!

This becomes particularly significant when you consider there are nearly 90,000 people on the waitlist for a Kidney Transplant, the average wait us about 3-5 years, 17 people die every day on the waitlist, every 8 minutes, someone is added to the list, and we only convert around 27,000 actual Kidney Transplants every year. This new study gives us hope that someday soon, everyone who wants or needs a Kidney Transplant, can have one. 

4. Why Is It Safer: The Risk Is Lower Due to Laparoscopic Procedures and Other Recent Improvements 

The authors of the study suggested that improved surgical techniques, more careful donor selection and better postoperative care are the reasons for such a marked improvement. This means the old estimate of 3 in 10, 000 donor deaths within 3 months needs to be updated! 

In previous decades, male donors and those with a history of high blood pressure were more likely to die within 90 days of the surgery and most of them passed within the first 7 days after surgery.  most often from excessive bleeding or hemorrhage. The Study validates that it is a very safe surgery with a very small risk.  

Hopefully, this will encourage more potential Living Kidney Donors to donate a Kidney to a needy Kidney Transplant Patient! The study demonstrates that Kidney Transplant Surgery is meeting the critical need to be as safe as possible for the charitable donor, who is required to be healthy enough to donor, without prior medical problems. Fortunately, the long-term medical data shows that Kidney Donors' Kidney Function tends to remain stable and the risk of developing chronic kidney disease is only slightly higher than those who do not donate.(NBC NEWS ARTICLE in blue print. Risk of End Stage Renal Disease Following Live Kidney Donation )

"While we had always understood that kidney donation is safe, our findings suggest that mortality among donors is extremely rare, and the procedure is safer than ever before,” said study lead author Allan B. Massie, PhD. Dr. Massie is a director of the Center for Surgical and Transplant Applied Research (C-STAR) Quantitative Core at NYU Grossman School of Medicine, where he is also a faculty member in the Departments of Surgery and Population Health.

Dr. Massie points out that laparoscopic surgery has drastically changed Kidney Transplants since the 1990's. Now instead of a large, gaping opening like the old  donor nephrectomy (kidney removal) with a 6" to 9" incision, the current laparoscopic nephrectomy removes the donor kidney through a much smaller backed up by the insertion of a surgical camera inserted via a thin tube for better vision.  

This new report from the Journal of The American Medical Association (JAMA) is the first since 2009 to look at the risk of death in kidney donors. During this updated time period, laparoscopic nephrectomies have become the standard practice in Kidney Transplants. 

Doctors are also taking better care of patients both before the operation and afterwards, following up with patients and checking their labs post-surgery. 

5. What Types of Potential Donors Could Face Rejection ?

The results of the study further indicate that potential donors who may be frequently rejected in the future may be with a history of high blood pressure, and some high risk males. Factors like age, race and ethnicity were found not to have any effect on mortality! The risk was greater for men and those with preexisting hypertension. 

6. How Was The Study Conducted?

The Study Team analized information from the Scientific Registry of Transplants Recipients and their database of Transplantation Centers  throughout the United States as overseen by the US Department of Health and Human Services. The Death Records were provided by the Organ Procurement and Transplant Network, a non-profit organization that is the only transportation network authorized by Congress to oversee national Kidney Transplants. 

The researchers calculated the mortality rates that occurred within 90 days of Kidney Donation between 1993-2002, & 2003 -2012 & 2013-2022. Then they compared deaths across these periods of time with demographics and health factors, including sex, body mass, (obesity)  & whether the donors had a laparoscopic surgery. 

The findings indicate the about  half the donor deaths occur within the first week of Donation, mostly because of blood loss. They found 13 deaths occurred before 2013, 18 happened between 2003-2012. Since 2013, only 5 donors died within 90 days of the surgery. 

7. Results

With only 1 donor death occurring in every 10, 000 Kidney Donations or 36 deaths in over 30 years and only 5 donors dying within 90 days of the transplant procedures, it us clear that the advice given before transplant needs to be updated to include the new statistical findings. This is a significant statistical drop of adults who died within 90 days of donating a Kidney!

8. Conclusions 

"While we had always understood that kidney donation is safe, our findings suggest that mortality among donors is extremely rare, and the procedure is safer than ever before,” said lead researcher Allan Massie, director of the NYU Grossman School of Medicine’s Center for Surgical and Transplant Applied Research Quantitative Core.

The risk to Kidney Donors is at an all time low, and Donors should be more encouraged to donate then ever. The risk of Kidney Donation is safer than it has ever been. This should encourage more Kidney Donations and lower the number of people waiting on the list. It should encourage more Living Donations and Pre-Emptive Kidney Transplants, all of which should encourage Kidney Patients!

Being able to reassure Donors that Living Kidney Donation is safe and getting safer is paramount because in the past, some potential recipients have been reluctant to accept a living kidney donation because of the potential risk to the donor. The findings of this study are reassuring to potential Living Kidney Donors, Recipients and all those connected to these people  (family members, caretakers , co-employees and friends) because now they don't have to worry about the donor dying from donating to the recipient. This should make it easier to obtain and keep the consent of the kidney donor!

Even the doctors are hopeful that reassuring data like this will ultimately help to solve the donor shortage in the U.S.

"Anything that comes along that says being a living donor is getting safer and safer over time will hopefully encourage more people to step forward and donate and give the gift of life,” said Dr. John Friedewald, medical director of the kidney transplant program at Northwestern Medicine.

9. References 

A. Thirty-Year Trends in Perioperative Mortality Risk for Living Kidney Donors

https://jamanetwork.com/journals/jama/article-abstract/2822922

B. Articles That Reference The JAMA Article 

I. Kidney Donor Mortality Plummets Over 30 Years

https://www.medscape.com/viewarticle/kidney-donor-mortality-plummets-over-30-years-2024a1000fop

ii. Thirty-Year Trends in Perioperative Mortality Risk for Living Kidney Donors

https://pubmed.ncbi.nlm.nih.gov/39196582/

iii. Thirty-year trends in perioperative mortality risk for living kidney donors

https://www.eurekalert.org/news-releases/1055594

iv. Kidney donors' risk of death at all-time low

https://www.sciencedaily.com/releases/2024/08/240828114340.htm

v. Mortality Risk Dropped for Living Kidney Donors Over the Past Decade

https://www.medpagetoday.com/nephrology/kidneytransplantation/111695

vi. 30-Year Trends in Perioperative Mortality for Kidney Donors

https://www.miragenews.com/30-year-trends-in-perioperative-mortality-for-1304744/

vii. Thirty-Year Trends in Perioperative Mortality Risk for Living Kidney Donors.

https://read.qxmd.com/read/39196582/thirty-year-trends-in-perioperative-mortality-risk-for-living-kidney-donors

viii. Perioperative Mortality Low for Living Kidney Donors

https://www.physiciansweekly.com/perioperative-mortality-low-for-living-kidney-donors/

ix. Perioperative Mortality Low for Living Kidney Donors

https://www.healthday.com/healthpro-news/kidney-health/perioperative-mortality-low-for-living-kidney-donors

X. Donating a kidney is even safer now than long thought, US study shows

https://medicalxpress.com/news/2024-08-donating-kidney-safer-thought.html

Xi. Insights Into Living Kidney Donor Health, Racial Disparities

https://www.renalandurologynews.com/features/insights-into-living-kidney-donor-health-racial-disparities/

xii. The True Risk of Living Kidney Donation

https://www.ncbi.nlm.nih.gov/pmc/

xiii. Lifetime Risks of kidney donation: a medical decision analysis

https://bmjopen.bmj.com/content/7/8/e016490

xiv. Long-term Medical Outcomes of Living Kidney Donors (LONG VERSION)

https://www.mayoclinicproceedings.org/article/S0025-6196(22)00368-8/fulltext

xv. Living Kidney Donor Follow-up: State-of-the-art and Future Directions

https://www.akdh.org/article/S1548-5595(12)00073-0/abstract

xvi. Kidney donation seen as ‘safe and getting safer

https://www.healio.com/news/nephrology/20240830/kidney-donation-seen-as-safe-and-getting-safer#:~:text=%E2%80%9CWe%20have%20long%20known%20kidney,Transplant%20Applied%20Research%20Qualitative%20Core

xvii. Donating a kidney is safer than ever, reassuring research finds

https://www.nbcnews.com/health/health-news/donating-kidney-safer-ever-new-research-finds-rcna168524

xviii. Donating a kidney is even safer now than long thought, US study shows

https://apnews.com/article/kidney-transplant-living-donor-54f6017f04f92f9bfef52ab13155511a

xix. https://www.wbay.com/2024/09/04/interview-new-research-shows-reduced-risk-living-kidney-donors/

xiv.  Donating a kidney even more safe than previous believed, U.S. study shows

 https://www.pbs.org/newshour/health/donating-a-kidney-even-more-safe-than-previous-believed-u-s-study-shows

xv.  Kidney Donors’ Risk of Death at All-Time Low

https://nyulangone.org/news/kidney-donors-risk-death-all-time-low

xvi. Donating a kidney is safer than ever, reassuring research finds

https://www.yahoo.com/news/donating-kidney-safer-ever-reassuring-182849446.html

xvii. It's Safer to Donate a Kidney Now Than at Any Time in History

https://www.healthday.com/health-news/general-health/its-safer-to-donate-a-kidney-now-than-at-any-time-in-history

xviii. Donating a kidney has never been safer, yet the Hong Kong donation rate remains low

https://www.scmp.com/lifestyle/health-wellness/article/3276814/donating-kidney-has-never-been-safer-yet-hong-kong-donation-rate-remains-low

xvix.  Kidney Donations Safer Than Previously Thought: Study

https://www.newsweek.com/kidney-donations-safer-previously-thought-study-finds-1945624