Improving the standards of living donor kidney transplantation

• Main Author: Lumsdaine, Jennifer A.
• Published: University of Edinburgh 2006
• Subjects: 616.89
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.654128

The aims of this thesis were to establish pattern of living donor assessment, selection criteria and follow-up practice throughout the United Kingdom; to measure the impact of living donor transplantation on quality of life and relationship issues for both donor and recipient; to ascertain if the act of donating a kidney causes short or long term physical or psychological harm to the donor; to determine the optimum follow-up practice for living donors and to explore if standards of living donor transplantation can be improved. Results showed that there remains variety in practice throughout the UK in procedures, although publication of national guidelines has provided a valuable framework. These studies have demonstrated that with rigorous donor assessment only those above UK average physical quality of life scores proceed to donation. The donors experience a transitory decrease in quality of life following the operation and have a small risk of major and a higher risk of minor complications.  Longer term the donors are not compromised by physical or psychological difficulties and experience an improved relationship with the recipient. Annual follow-up is provided for those donors who wish to attend and the majority of donors do not worry about living with one kidney. The clinical benefits of living donor transplant for the recipient are well-recognised. The assessment process appears to preclude those who may suffer psychological impairment from receiving a kidney from a living donor in this study group. The recipient enjoys an improved quality of life and relationships with both the donor and other family members. Initial high level of concern about the donor decreases after the operation.