Living Kidney Donation and Long-Term Outcomes
Summary
Living kidney donation has become a vital response to the global shortfall in donor organs, offering superior graft survival and reduced waiting times compared with deceased donation. Advances in surgical techniques and donor evaluation have minimised perioperative risks, while long-term surveillance has clarified both physiological adaptations and potential sequelae in donors. After nephrectomy, the remaining kidney undergoes compensatory structural and functional changes, including glomerular hyperfiltration and hypertrophy, which preserve overall filtration capacity. Most donors maintain stable renal function, low cardiovascular risk and high quality of life over decades, provided pre-donation health assessments and post-donation follow-up are rigorous. Emerging evidence highlights individual variability in compensatory capacity, the influence of metabolic factors on renal trajectories and the need for tailored monitoring to safeguard donor health without dissuading altruistic giving.
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Living Kidney Donation and Long-Term Outcomes publication trend
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Technical terms
Estimated glomerular filtration rate (eGFR): A calculated measure of kidney filtration capacity, based on serum creatinine, age, sex and body size.
Glomerular hyperfiltration: A compensatory increase in filtration rate of the remaining nephrons following nephrectomy, reflecting renal reserve adaptation.
Propensity score matching: A statistical technique used to create comparable groups in observational studies by balancing potential confounding variables.
References
- Early increase in single-kidney glomerular filtration rate after living kidney donation predicts long-term kidney function. Kidney International (2022).
- Long-term prognosis after kidney donation: a propensity score matched comparison of living donors and non-donors from two population cohorts. European Journal of Epidemiology (2020).
- Long term metabolic and renal outcomes of kidney donors compared to controls with excellent kidney function. BMC Nephrology (2019).
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