Initial Experiences in Starting a Renal Transplant Center: Ab-initio profile of donors we encountered

Abstract

Introduction: Kidney transplantation is the ultimate treatment for people with ESRD. The Donors for such kidney can be either from living or from cadaver donors. The living donors are healthy people who are thoroughly worked up and screened. For the benefit of another person we subject a healthy subject to surgery. For this reason a study on how a donor’s health is affected as a result of kidney donation needs evaluation.

Methods: This study is a combined retrospective and prospective study. The retrospective data were taken from the case sheet of patients maintained at the urology department of a large tertiary level hospital doing renal transplants. Prospective study of the cases were carried out by following up detail donor workup including history, clinical examination and investigations relevant to donor work up as per the protocol followed in the transplant center. Each prospective case were studied for complications of donor nephrectomy and followed up for a period of up to one year after donor nephrectomy. 

Results: A total of 36 donors underwent donor nephrectomy during the study period. There were only two laparoscopic nephrectomies and 34 by standard retroperitoneal open surgical method. 13 donors had postoperative complications (36.11%). The duration of stay varied from 5-35 days. Majority of the donors (44%) had a stay within the range of 10-15 days, followed by a stay of 5-10 days (30-56 percent of the donors). The remaining stay ranged from 2.78% to 8.33 %. The average stay in the hospital was found to be 14.17 days with SD of 6.45 days.

Conclusion: Living kidney donation with all its advantages still holds the best solution for end stage renal disease. The inconvenience of haemodialysis along with the cost and loss of labour of a patient on haemodialysis makes renal transplant the ultimate replacement of a non-functioning kidney. The advantage of timing of transplantion according to the condition of the recipient makes it far superior than cadaver grafts.