Singapore study shows live kidney donation does not contribute to poorer health

20161201110000, Brenda Lau
Support is provided for patients to undergo dialysis but live kidney transplants are the best option
Support is provided for patients to undergo dialysis but live kidney transplants are the best option
Four in 10 kidney donors regain 75% of their pre-donation kidney function after five years, according to a collaborated study by Singapore General Hospital (SGH) and Duke-NUS Medical School. The specific study is believed to be the largest in Southeast Asia.

Despite having only one kidney after a transplant, it was found that donors lead healthy lives and are not at a higher risk of kidney failure or dying compared to the general population.

High rates of kidney failure, low rates of donors

The team studied 180 living kidney donors at SGH from 1976 to 2012. The average follow-up period of these patients was 11 years, of which doctors examined their blood pressure, kidney function and urine tests during medical check-ups. It was also noted that kidney function in donors also stabilised after about a decade.

The authors of the study hope that their findings will persuade more of the public to consider being a living donor, to address the low rates of kidney donation.

"The kidney function is actually not declining. We've removed your kidney but the kidney function tends to gradually increase... It's a very gradual, slow process and then it tends to stabilise. After stabilising, there will not be a dip," said Duke-NUS Programme in Health Services' professor Tazeen H. Jafar, an author of the study.

Singapore is one of the top five countries in the world with the highest incidence rates of kidney failure. The last reported figure from the Renal Registry in 2014, saw 1,730 individuals suffering from kidney failure.

The National Kidney Foundation (NKF) of Singapore states that there are currently 400 patients waiting for a cadaveric transplant and the average wait is nine years. Whilst the NKF provides support for patients to undergo dialysis, live kidney transplants are still the best option - especially if they are suffering from end-stage kidney failure. The patients will have higher survival rates than those who undergo dialysis.

Yet, the National Organ Transplant Unit, Ministry of Health have published figures showing that only 5.1% of those on the waiting list for kidney transplants managed to receive transplants from living donors for the first half of this year - 16 out of 310. As for cadaveric kidney transplants, there were only 6.1% for the same period - 19 out of 310.

Potential donors worry about surgical risks and decline in health

The team cited a 2012 study which found that the main reasons why potential donors refuse to consider being a live kidney donor was due to the fear of surgical risks and the possibility of poorer health after donation.

However, Dr. Terence Kee, director of the renal transplant programme at SGH, said the risk of complications arising from surgical procedures for kidney transplants range from 1% to 5%.

The global statistic for the risk of death from a donor surgery is one in 3,000, which is considered to be very low, as low as undergoing an appendix operation, he added.

To lay rest to claims of poorer health after donation, the researchers say one in 2,000 individuals are born with renal agenesis, yet lead a normal quality of life and survive as long as individuals who are born with two kidneys.

Dr. Tan Ru Yu, associate consultant from SGH's department of renal medicine and lead author of the study, said end-stage kidney failure patients wait close to ten years for a cadaveric kidney donor transplant.

"But the best option for them is a transplant from a living donor as outcomes are better. We hope the findings of our study will encourage more people to consider being a living donor, more so if the patient is their loved one," she added. MIMS

Read more:
Man has world’s largest kidneys weighing 13kg removed
Why patients receiving organs from deceased donors have higher risk of cancer
How aware are you of your patients’ religious concerns over organ donations?

Sources:
http://www.straitstimes.com/singapore/health/living-donor-not-at-higher-risk-of-kidney-failure-study
http://www.nkfs.org/treatment/kidney-transplant/about-kidney-transplant/