| Expanding the donor pool: living donor nephrectomy in the elderly and the overweight. | |
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MedLine Citation:
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PMID: 22495495 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Increasing demand for donor kidneys, in parallel with trends toward more elderly and obese populations, make it important to continuously review donor pool inclusion criteria. Acceptance of elderly and obese living donors remains controversial, with a higher incidence of comorbidity and the greater risk of postoperative complications sighted as reasons for caution. Drawing on our center's experience, we aim to determine whether older age and obesity are in fact associated with greater perioperative risk, and longer term complications in donors undergoing nephrectomy. METHODS: Three hundred eighty-three living donor nephrectomies conducted at one of the United Kingdom's largest transplant units over the last 5 years were stratified into groups according to age and body mass index. Perioperative endpoints and postdonation follow-up data collected at 6-to-12-monthly intervals were analyzed and compared. RESULTS: No significant differences in operative parameters, including operative time and estimated blood loss, were reported between groups. Rates of early postoperative complications were not significantly different, although subgroup analysis showed a higher incidence of respiratory complications at the extremes of obesity (body mass index ≥ 40 kg/m²). On follow-up, renal function parameters showed significant change postnephrectomy, but between-group variation was not significant. Mortality and major complication rates were comparably low in all groups of study. CONCLUSIONS: In our unit's experience, nephrectomy in selected donors who may otherwise have been precluded from participation on account of their age or weight, is feasible and associated with perioperative and longer term outcomes comparable with their younger nonobese counterparts. It provides a basis for informed consent of "extended criteria" donors. |
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Authors:
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Benjamin O'Brien; Sotiris Mastoridis; Atika Sabharwal; Nadey Hakim; David Taube; Vassilios Papalois |
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Publication Detail:
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Type: Evaluation Studies; Journal Article |
Journal Detail:
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Title: Transplantation Volume: 93 ISSN: 1534-6080 ISO Abbreviation: Transplantation Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-06-12 Completed Date: 2012-08-16 Revised Date: 2013-02-25 |
Medline Journal Info:
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Nlm Unique ID: 0132144 Medline TA: Transplantation Country: United States |
Other Details:
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Languages: eng Pagination: 1158-65 Citation Subset: IM |
Affiliation:
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Translational Medicine and Therapeutics, William Harvey Research Institute, Barts and The London School of Medicine, London, United Kingdom. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Age Factors Aged Blood Loss, Surgical / statistics & numerical data Body Mass Index Donor Selection / methods* Female Follow-Up Studies Humans Kidney Transplantation* Living Donors* Male Middle Aged Nephrectomy* / mortality Obesity Outcome Assessment (Health Care) Overweight* Postoperative Complications / epidemiology Retrospective Studies |
| Comments/Corrections | |
Comment In:
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J Urol. 2013 Feb;189(2):623
[PMID:
23312186
]
Transplantation. 2012 Jun 15;93(11):1092-3 [PMID: 22466788 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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