One is as good as two, it seems, when it comes to kidneys.† For kidney donors live as long as those who don't donate, says a study published March 10 in†JAMA, The Journal of the American Medical Associationó60 years after the first kidney transplant in the U.S. The study found no increase in mortality in donors once they recover from the operation.
Each year, more than 6,000 healthy people in the U.S.†donate a kidney†to someone they know. About half are blood relatives of the kidney recipient. The other half are spouses, friends or acquaintances. But about 100 come forward wishing to anonymously give the gift of glomeruli (the basic filtration units of the kidney) to someone they've never met.
Transplant surgeon Dorry Segev and his team from Johns Hopkins University School of Medicine in Baltimore studied mortality among 80,000 kidney donors over the past 15 years, comparing them to healthy people with both kidneys.
"All these folks are heroes making a big difference in someone else's life," says Dorry Segev, describing the willingness of donors "to undergo an operation which carries a risk and gives them no benefit." You†only need one kidney to live. But the operation required to remove a kidney and the risk of developing disease in the remaining one later in life make the decision to donate not one to be taken lightly. "It's our job to quantify the risks and make sure those risks stay as small as they can," Segev says. "With this study we're able to say that whatever happens to people physiologically after kidney donationóit doesn't cause a premature death," Segev says. "After donating a kidney a person can live exactly the way they lived before donatingóa long, healthy, active life with virtually no restrictions at all."
Whereas the mortality rate was no different among donors and healthy people one year after donation, three in 10,000 donors died within 90 days after surgeryóa surgical mortality rate one sixth that for gall bladder removal and one fortieth that for nondonor kidney removal. Males, African-Americans and sufferers of hypertension were at a higher risk for postoperative deathóa finding that Segev says is consistent with the general risk of surgery.
Segev hopes that the study will make people more aware of the major problems surrounding kidney disease, such as the profound†organ shortage, wait-list mortality, and the poor quality of life for people on dialysis. "I hope that those things will inspire donors, and that our study will help quantify the risks so they can make intelligent choices," Segev says. Although donors are carefully screened before the procedure, he stresses that there are risks. "It's still a major operation. You're still living with one kidney. People still need to think about it and be aware of the risks in taking on this heroic act," he says. Donors are advised to see a doctor once a year after removal, in hopes that any trouble (like disease in the remaining kidney) would be caught early.