Living‐unrelated kidney donation: a single‐center experience

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Abstract
For 140 consecutive renal transplants performed from January 1995 to October 1997, 25 (18%) were from living‐unrelated donors (15 women, 10 men, aged 25–63, mean 43 yr). All donors had pre‐transplant imaging evaluation of renal anatomy following renal function assessment (minimal creatinine clearance 75 cm3/min). Admission to the hospital on the day of donation preceded nephrectomy under general anesthesia using an anterior flank, extra‐retroperitoneal approach (no rib resection). Post‐operative epidural pain control was used for all but 1 donor. The 25 kidney donors were hospitalized for 2 (n=1), 3 (n=12), 4 (n=7), or 5–8 d (n=5) (average 3.9 d) and had a mean hospitalization charge of $15 501 (range $10 808–$29 579). One intra‐operative hemorrhage required transfusion; 1 late neural‐related pain syndrome required outpatient wound exploration. Two kidneys were lost: a husband recipient from repetitive acute rejections at 3 months; a friend recipient from chronic rejection at 2.5 yr; both await cadaver transplant. The other 23 kidneys are functioning with a mean serum creatinine of 1.8 (range 1.0–3.3) at 3–36 months (patient survival 100%; graft survival 92%). While most donors were spouses (8 husbands and 10 wives), friends, distant cousins, in‐laws, and adoptive relatives did well as donors and recipients. Transplantation may increase by 20% or more at centers which encourage broad application of living donor nephrectomy.