Health‐Related Quality of Life in Kidney Donors From the Last Five Decades: Results From the RELIVE Study

Abstract

Live donation benefits recipients, but the long‐term consequences for donors remain uncertain. Renal and Lung Living Donors Evaluation Study surveyed kidney donors (N = 2455; 61% women; mean age 58, aged 24–94; mean time from donation 17 years, range 5–48 years) using the Short Form‐36 Health Survey (SF‐36). The 95% confidence intervals for White and African‐American donors included or exceeded SF‐36 norms. Over 80% of donors reported average or above average health for their age and sex (p < 0.0001). Donors' age–sex adjusted physical component summary (PCS) scores declined by half a point each decade after donation (p = 0.0027); there was no decline in mental component summary (MCS) scores. White donors' PCS scores were three points higher (p = 0.0004) than non‐Whites'; this difference remained constant over time. Nine percent of donors had impaired health (PCS or MCS score >1 SD below norm). Obesity, history of psychiatric difficulties and non‐White race were risk factors for impaired physical health; history of psychiatric difficulties was a risk factor for impaired mental health. Education, older donation age and a first‐degree relation to the recipient were protective factors. One percent reported that donation affected their health very negatively. Enhanced predonation evaluation and counseling may be warranted, along with ongoing monitoring for overweight donors. Questionnaires completed by 2544 living donors 5 to 48 years postnephrectomy show that 80% have average or better health‐related quality of life for their age and sex based on SF‐36 norms and that obesity, history of psychiatric difficulties and nonwhite race are risk factors for poor health‐related quality of life outcomes, whereas being older, having more education and/or being a first‐degree relation to the recipient predict better outcomes.