Carlos Garcia-Ochoa1, Liane S Feldman2, Chris Nguan3, Mauricio Monroy-Caudros4, Jennifer B Arnold1, Lianne Barnieh1, Neil Boudville5, Meaghan S Cuerden1, Christine Dipchand6, John S Gill3, Martin Karpinski7, Scott Klarenbach8, Greg Knoll9, Charmaine E Lok10, Matthew Miller11, G V Ramesh Prasad12, Jessica M Sontrop13, Leroy Storsley7, Amit X Garg13,14,15. 1. London Health Sciences Centre, ON, Canada. 2. Department of Surgery, McGill University Health Centre, Montreal, QC, Canada. 3. The University of British Columbia, Vancouver, Canada. 4. Foothills Medical Center, University of Calgary, AB, Canada. 5. Medical School, Department of Renal Medicine, Sir Charles Gairdner Hospital, The University of Western Australia, Perth, Australia. 6. Division of Nephrology, Dalhousie University, Halifax, NS, Canada. 7. University of Manitoba, Winnipeg, Canada. 8. Division of Nephrology, University of Alberta, Edmonton, Canada. 9. Division of Nephrology, Department of Medicine, University of Ottawa, ON, Canada. 10. University of Toronto, ON, Canada. 11. Division of Nephrology and Transplantation, St. Joseph's Healthcare Hamilton, McMaster University, Hamilton, ON, Canada. 12. St. Michael's Hospital, Toronto, ON, Canada. 13. Department of Epidemiology & Biostatistics, Western University, London, ON, Canada. 14. Department of Medicine, Western University, London, ON, Canada. 15. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
Abstract
BACKGROUND: Although living kidney donation is safe, some donors experience perioperative complications. OBJECTIVE: This study explored how perioperative complications affected donor-reported health-related quality of life, depression, and anxiety. DESIGN: This research was a conducted as a prospective cohort study. SETTING: Twelve transplant centers across Canada. PATIENTS: A total of 912 living kidney donors were included in this study. MEASUREMENTS: Short Form 36 health survey, Beck Depression Inventory and Beck Anxiety Inventory. METHODS: Living kidney donors were prospectively enrolled predonation between 2009 to 2014. Donor perioperative complications were graded using the Clavien-Dindo classification system. Mental and physical health-related quality of life was assessed with the 3 measurements; measurements were taken predonation and at 3- and 12-months postdonation. RESULTS: Seventy-four donors (8%) experienced a perioperative complication; most were minor (n = 67 [91%]), and all minor complications resolved before hospital discharge. The presence (versus absence) of a perioperative complication was associated with lower mental health-related quality of life and higher depression symptoms 3-month postdonation; neither of these differences persisted at 12-month. Perioperative complications were not associated with any changes in physical health-related quality of life or anxiety 3-month postdonation. LIMITATIONS: Minor complications may have been missed and information on complications postdischarge were not collected. No minimal clinically significant change has been defined for kidney donors across the 3 measurements. CONCLUSIONS: These findings highlight a potential opportunity to better support the psychosocial needs of donors who experience perioperative complications in the months following donation. TRIAL REGISTRATION: NCT00319579 and NCT00936078.
BACKGROUND: Although living kidney donation is safe, some donors experience perioperative complications. OBJECTIVE: This study explored how perioperative complications affected donor-reported health-related quality of life, depression, and anxiety. DESIGN: This research was a conducted as a prospective cohort study. SETTING: Twelve transplant centers across Canada. PATIENTS: A total of 912 living kidney donors were included in this study. MEASUREMENTS: Short Form 36 health survey, Beck Depression Inventory and Beck Anxiety Inventory. METHODS: Living kidney donors were prospectively enrolled predonation between 2009 to 2014. Donor perioperative complications were graded using the Clavien-Dindo classification system. Mental and physical health-related quality of life was assessed with the 3 measurements; measurements were taken predonation and at 3- and 12-months postdonation. RESULTS: Seventy-four donors (8%) experienced a perioperative complication; most were minor (n = 67 [91%]), and all minor complications resolved before hospital discharge. The presence (versus absence) of a perioperative complication was associated with lower mental health-related quality of life and higher depression symptoms 3-month postdonation; neither of these differences persisted at 12-month. Perioperative complications were not associated with any changes in physical health-related quality of life or anxiety 3-month postdonation. LIMITATIONS: Minor complications may have been missed and information on complications postdischarge were not collected. No minimal clinically significant change has been defined for kidney donors across the 3 measurements. CONCLUSIONS: These findings highlight a potential opportunity to better support the psychosocial needs of donors who experience perioperative complications in the months following donation. TRIAL REGISTRATION: NCT00319579 and NCT00936078.
Authors: K L Lentine; N N Lam; D Axelrod; M A Schnitzler; A X Garg; H Xiao; N Dzebisashvili; J D Schold; D C Brennan; H Randall; E A King; D L Segev Journal: Am J Transplant Date: 2016-03-10 Impact factor: 8.086
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