Transplant Trial Watch

Risks for donors associated with living kidney donation: meta-analysis.

Bellini, M. I., et al.

British Journal of Surgery 2022 [record in progress].

This study aimed to investigate the effect of age, sex, body mass index (BMI) and ethnicity on short and long term outcomes for living kidney donors.

Electronic databases including Cochrane, Ovid, and Web of Science were searched. Study screening and data extraction were performed by two independent reviewers. The National Heart, Lung, and Blood Institute quality assessment tool was used to assess the methodological quality of the included studies.

31 studies were included in the review.

The primary outcome was the effect of donor demographics (ethnicity, BMI, age, and sex) on kidney function. The secondary outcomes included the effect of donor demographics on the incidence of end-stage renal disease (ESRD), serum creatinine level, donor survival, incidence of proteinuria, blood pressure (BP), de novo hypertension, and surgical complications.


CET Conclusions
This systematic review and meta-analysis aimed to investigate the impact of donor age, sex, body mass index and ethnicity on the outcome for living kidney donors. Analysis of data from 31 observational studies demonstrated inferior outcomes in male donors, and those with a BMI greater than 30 kg/m2. African donors were found to be more likely to develop renal failure in the long-term than younger donors. Whilst some of the findings are perhaps not too surprising (reflecting the same outcomes in the general population), these data do help in the personalisation of risk assessment for donors and highlight the importance of robust follow-up for higher risk groups. It should be noted that the nature of the review question means that only observational data can be used, most of which is retrospective in nature and prone to high heterogeneity. Nonetheless, this represents a large analysis of the body of published literature on this topic

Trial registration
PROSPERO - CRD42020207052

Funding source
Not reported