Main Article Content
Abstract
Objetive: To describe the care needs of the kidney donor candidate; the socio-demographic and clinical characteristics; and to analyse the results from a gender perspective.
Material and Method: Cross-sectional descriptive observational study. Clinical and socio-demographic data, number and type of visits and clinical tests performed during 2020 were collected.
Results: Sixty kidney donor candidates (n=37 women; 61.67%) with a mean age of 51.98±14.50 years and a median of 2.5 [RIQ (0.69-5.29)] months of study were included. 16 (26.67%) were eligible for donation, corresponding to 14.16% of the Renal Transplant (RT) activity of the reference centre. 757 visits were required (20.60% of the activity) of which 341 (45.05%) were visits with a nurse. 423 tests (19.60% of the activity) were required during the study. A mean of 1.87±1.35 cardiovascular risk factors was identified in the sample analysed, being 1.56±0.81 in those who were donors. More women (n=12; 75%) than men (n=4; 25%) were ultimately renal donors.
Conclusions: The study of kidney donor candidates is complex and involves twice as much activity as that of kidney transplant recipient candidates. The process ends in donation in 27% of the candidates studied. The nurse concentrates 45% of the visits required. Strategies need to be explored to optimise the study process. There are gender differences in the predisposition to be studied voluntarily as a kidney donor candidate.
Keywords
Article Details
Copyright (c) 2022 Guillermo Pedreira-Robles, Victoria Morín-Fraile, Anna Bach-Pascual, Dolores Redondo-Pachón, Marta Crespo, Paloma Garcimartín

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Funding data
-
Departament de Salut, Generalitat de Catalunya
Grant numbers SLT017/20/000001
References
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References
Vanholder R, Annemans L, Brown E, Gansevoort R, Gout-Zwart JJ, Lameire N, et al. Reducing the costs of chronic kidney disease while delivering quality health care: a call to action. Nat Rev Nephrol. 2017;13:393-409. DOI: https://doi.org/10.1038/nrneph.2017.63
Alhamad T, Axelrod D, Lentine KL. The epidemiology, outcomes, and costs of contemporary kidney transplantation. En: Himmelfarb J, Ikizler TA (Eds.). Chronic Kidney Disease, Dialysis, and Transplantation: A Companion to Brenner and Rector’s the Kidney. 4ª ed. Filadelfia; Elsevier: 2019. p. 539-54. DOI: https://doi.org/10.1016/B978-0-323-52978-5.00034-3
Lentine KL, Pastan S, Mohan S, Reese PP, Leichtman A, Delmonico FL, et al. A roadmap for innovation to advance transplant access and outcomes: a position statement from the National Kidney Foundation. American Journal of Kidney Diseases. 2021;78(3):319-32. DOI: https://doi.org/10.1053/j.ajkd.2021.05.007
Organización Nacional de Trasplantes. Actividad de donación y trasplante renal en España 2020 [Internet]. 2020 [consultado Ago 2021]. Disponible en: http://www.ont.es/infesp/Memorias/ACTIVIDAD%20DE%20DONACI%C3%93N%20Y%20TRASPLANTE%20RENAL%20ESPA%C3%91A%202020.pdf.
Coll E, Miranda B, Domínguez-Gil B, Martín E, Valentín M, Garrido G, et al. Donantes de órganos en España: evolución de las tasas de donación por comunidades autónomas y factores determinantes. Med Clin (Barc). 2008;131(2):52-9. DOI: https://doi.org/10.1157/13123486
Lentine KL, Lam NN, Segev DL. Risks of Living Kidney Donation: Current State of Knowledge on Outcomes Important to Donors. Clin J Am Soc Nephrol. 2019;14(4):597-608.
Moore DR, Serur D, Rudow DL, Rodrigue JR, Hays R, Cooper M. Living donor kidney transplantation: improving efficiencies in live kidney donor evaluation - recommendations from a consensus conference. Clin J Am Soc Nephrol. 2015;10(9):1678-86. DOI: https://doi.org/10.2215/CJN.01040115
Andrews PA, Burnapp L. British Transplantation Society / Renal Association UK Guidelines for Living Donor Kidney Transplantation. Transplantation. 2018;102(7):307. DOI: https://doi.org/10.1097/TP.0000000000002253
Lentine KL, Kasiske BL, Levey AS, Adams PL, Alberú J, Bakr MA, et al. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(supl 1):S1-109. DOI: https://doi.org/10.1097/TP.0000000000001769
European Renal Best Practice Transplantation Guideline Development Group. ERBP Guideline on the Management and Evaluation of the Kidney Donor and Recipient. Nephrol Dial Transplant. 2013;28(supl 2):S1-71. DOI: https://doi.org/10.1093/ndt/gft218
Mahíllo Durán B. Modelo organizativo y fuentes de información en donación y trasplantes de órganos. Índice. 2016;66:14-19.
Organización Mundial de la Salud (OMS). Principios Rectores de trasplante de órganos, células y tejidos de la Organización Mundial de la Salud [Internet]. 2010 [consultado Ago 2021]. Disponible en: https://www.who.int/transplantation/Guiding_PrinciplesTransplantation_WHA63.22sp.pdf.
Parlamento Europeo. Directiva 2010/53/UE del Parlamento Europeo y del Consejo, de 7 de julio de 2010, sobre normas de calidad y seguridad de los órganoshumanos destinados al trasplante [Internet]. 2010 [consultado Ago 2021]. Disponible en: https://www.boe.es/doue/2010/207/L00014-00029.pdf.
Boletín Oficial del Estado. Ley 30/1979, de 27 de octubre, sobre extracción y trasplante de órganos. 1979 [consultado Ago 2021]. Disponible en: https://www.boe.es/eli/es/l/1979/10/27/30.
Locke JE, Reed RD, Massie A, MacLennan PA, Sawinski D, Kumar V, et al. Obesity increases the risk of end-stage renal disease among living kidney donors. Kidney Int. 2017;91(3):699-703. DOI: https://doi.org/10.1016/j.kint.2016.10.014
Sawinski D, Locke JE. Evaluation of Kidney Donors: Core Curriculum 2018. Am J Kidney Dis. 2018;71(5):737-47. DOI: https://doi.org/10.1053/j.ajkd.2017.10.018
Lentine KL, Lam NN, Segev DL. Risks of Living Kidney Donation: Current State of Knowledge on Outcomes Important to Donors. Clin J Am Soc Nephrol. 2019;14(4):597-608. DOI: https://doi.org/10.2215/CJN.11220918
Bentata Y. Obesity in Living-Donor Kidney Transplant: What Risks for the Donor and the Recipient? Exp Clin Transplant. 2021;19(4):287-96. DOI: https://doi.org/10.6002/ect.2020.0074
Price AM, Edwards NC, Hayer MK, Moody WE, Steeds RP, Ferro CJ, et al. Chronic kidney disease as a cardiovascular risk factor: lessons from kidney donors. J Am Soc Hypertens. 2018;12(7):497-505.e4. DOI: https://doi.org/10.1016/j.jash.2018.04.010
O’Keeffe LM, Ramond A, Oliver-Williams C, Willeit P, Paige E, Trotter P, et al. Mid- and Long-Term Health Risks in Living Kidney Donors: A Systematic Review and Meta-analysis. Ann Intern Med. 2018;168(4):276-84. DOI: https://doi.org/10.7326/M17-1235
Lam NN, Lentine KL, Garg AX. Renal and cardiac assessment of living kidney donor candidates. Nat Rev Nephrol. 2017;13(7):420-28. DOI: https://doi.org/10.1038/nrneph.2017.43
Basiri A, Taheri M, Khoshdel A, Golshan S, Mohseni-Rad H, Borumandnia N, et al. Living or deceased-donor kidney transplant: the role of psycho-socioeconomic factors and outcomes associated with each type of transplant. Int J Equity Health. 2020;19(1):79. DOI: https://doi.org/10.1186/s12939-020-01200-9
Organización Nacional de Trasplantes (ONT). Plan de acción para la mejora de la donación y el trasplante de órganos [Internet]. 2008 [consultado Ago 2021]. Disponible en: http://www.ont.es/infesp/ProyectosEnMarcha/Plan%20Donaci%C3%B3n%20Cuarenta.pdf.
Getchell LE, McKenzie SQ, Sontrop JM, Hayward JS, McCallum MK, Garg AX. Increasing the Rate of Living Donor Kidney Transplantation in Ontario: Donor- and Recipient-Identified Barriers and Solutions. Can J Kidney Health Dis. 2017;4:2054358117698666. DOI: https://doi.org/10.1177/2054358117698666
de diciembre, por el que se regulan las actividades de obtención y utilización clínica de órganos humanos y la coordinación territorial en materia de donación y trasplante de órganos y Tejidos [Internet]. 2000 [consultado Ago 2021]. Disponible en: https://www.boe.es/buscar/doc.php?id=BOE-A-2000-79.
Shukhman E, Hunt J, LaPointe-Rudow D, Mandelbrot D, Hays RE, Kumar V, et al. Evaluation and care of international living kidney donor candidates: Strategies for addressing common considerations and challenges. Clin Transplant. 2020;34(3):e13792. DOI: https://doi.org/10.1111/ctr.13792
Gill JS, Delmonico F, Klarenbach S, Capron AM. Providing Coverage for the Unique Lifelong Health Care Needs of Living Kidney Donors Within the Framework of Financial Neutrality. Am J Transplant. 2017;17(5):1176-81. DOI: https://doi.org/10.1111/ajt.14147
Weng FL, Lee DC, Dhillon N, Tibaldi KN, Davis LA, Patel AM, et al. Characteristics and Evaluation of Geographically Distant vs Geographically Nearby Living Kidney Donors. Transplant Proc. 2016;48(6):1934-9. DOI: https://doi.org/10.1016/j.transproceed.2016.03.042
Habbous S, McArthur E, Sarma S, Begen MA, Lam NN, Manns B, et al. Potential implications of a more timely living kidney donor evaluation. Am J Transplant. 2018;18(11):2719-29. DOI: https://doi.org/10.1111/ajt.14732
Habbous S, Arnold J, Begen MA, Boudville N, Cooper M, Dipchand C, et al. Duration of Living Kidney Transplant Donor Evaluations: Findings From 2 Multicenter Cohort Studies. Am J Kidney Dis. 2018;72(4):483-98. DOI: https://doi.org/10.1053/j.ajkd.2018.01.036
Weng FL, Morgievich MM, Kandula P. The Evaluation of Living Kidney Donors: How Long Is Too Long? Am J Kidney Dis. 2018;72(4):472-4. DOI: https://doi.org/10.1053/j.ajkd.2018.07.001
Graham JM, Courtney AE. The Adoption of a One-Day Donor Assessment Model in a Living Kidney Donor Transplant Program: A Quality Improvement Project. Am J Kidney. 2018;71(2):209-15. DOI: https://doi.org/10.1053/j.ajkd.2017.07.013
Schick-Makaroff K, Hays RE, Hunt J, Taylor LA, Rudow DL. Education Priorities and What Matters to Those Considering Living Kidney Donation. Prog Transplant. 2021;31(1):32-9. DOI: https://doi.org/10.1177/1526924820978599
Punjala SR, Adamjee Q, Silas L, Gökmen R, Karydis N. Weight trends in living kidney donors suggest predonation counselling alone lacks a sustainable effect on weight loss: a single centre cohort study. Transpl Int. 2021;34(3):514-24. DOI: https://doi.org/10.1111/tri.13816
Mustian MN, Hanaway M, Kumar V, Reed RD, Shelton BA, Grant R, et al. Patient Perspectives on Weight Management for Living Kidney Donation. J Surg Res. 2019;244:50-6. DOI: https://doi.org/10.1016/j.jss.2019.06.026
Eno AK, Thomas AG, Ruck JM, Van Pilsum Rasmussen SE, Halpern SE, Waldram MM, et al. Assessing the Attitudes and Perceptions Regarding the Use of Mobile Health Technologies for Living Kidney Donor Follow-Up: Survey Study. JMIR Mhealth Uhealth. 2018;6(10):e11192. DOI: https://doi.org/10.2196/11192
LaPointe Rudow D, Hays R, Baliga P, Cohen DJ, Cooper M, Danovitch GM, et al. Consensus Conference on Best Practices in Live Kidney Donation: Recommendations to Optimize Education, Access, and Care. American Journal of Transplantation. 2015;15:914-22. DOI: https://doi.org/10.1111/ajt.13173
Waterman AD, Morgievich M, Cohen DJ, Butt Z, Chakkera HA, Lindower C, et al. Living Donor Kidney Transplantation: Improving Education Outside of Transplant Centers about Live Donor Transplantation--Recommendations from a Consensus Conference. Clin J Am Soc Nephrol. 2015;10(9):1659-69. DOI: https://doi.org/10.2215/CJN.00950115
García-Martínez M, Calderari Fernández E, Sánchez Bercedo S, Martínez Alpuente I, Valentín Muñoz MO. El trasplante renal de donante vivo: una opción terapéutica en Enfermedad Renal Crónica Avanzada. Enferm Nefrol. 2019;22(2):124-8. DOI: https://doi.org/10.4321/S2254-28842019000200003
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