Perioperative mortality for living kidney donors drops significantly

Editor's Note

A recent study analyzing 30 years of national registry data shows a significant decline in perioperative mortality among living kidney donors, MedPage Today August 28 reports. From 2013 to 2022, the mortality rate within 90 days post-donation was 0.9 per 10,000 donations, compared to 2.9 per 10,000 in the 2003–2012 period and 3.0 per 10,000 in the 1993–2002 period.

The study, originally published by JAMA Network in an August 28 research letter, emphasized that current donor mortality rates are much lower than previous estimates. The authors suggest that guidelines, such as those from the 2017 Kidney Disease: Improving Global Outcomes (KDIGO), should be updated to reflect these improvements reflecting advancements in surgical techniques, donor selection, and perioperative care.

Most deaths were due to hemorrhage, infection, pulmonary embolism, and cardiovascular causes. Male donors and those with pre-donation hypertension had higher mortality rates. The study also found that mortality was higher for open nephrectomy compared to laparoscopic nephrectomy, although this was not statistically significant. The findings reflect the need for revised guidelines to better inform potential donors about current reduced risks associated with kidney donation, emphasizing that kidney donation is safer than ever before.