Live Kidney Donor Survival Rates Next to Normal
New results may allay possible donors’ and families’ fears.
Laparoscopic surgery is performed in an operating theater during a kidney transplant operation. Photo by
Frances Roberts / Alamy.
L
ong-term survival rates
for live kidney donors ap­
pear to be similar to those
for healthy nondonor counter­
parts, according to a cohort study
in the United States that exam­
ined 15 years of outcomes among
more than 80,000 live kidney
donors. The need for careful selec­
tion among higher-risk groups
was acknowledged—the risk of
death is higher in men and in all
black donors, for instance—as
was the need for discussion of
those risks with possible donors,
but the investigators concluded
that their study was large enough
to show that current practices are
“reasonable and safe,” as well as
a valid tool for addressing “the
profound shortage in deceased
donor organs.”
The results, published in
March, confirmed what nurses
who work with living transplant
donors have observed for years.
“Carefully selected donors go on
to live healthy lives, often with
an elevated sense of well-being,”
says Patricia McDonough, who
has been the coordinator of
18 AJN ▼ June 2010 ▼ Vol. 110, No. 6 ajnonline.com
hope that the published results
will dispel fear and offset mis­
conceptions in potential do­nors
and their families.
Those who have chosen to
donate their kidneys, like Jim
Melwert, a 35-year-old Pennsyl­
vania journalist who donated
his right kidney in 2006, under­
stand that this is crucial. “Not
only was it a revelation to learn
that I wouldn’t have to make
big changes to my lifestyle after
the procedure, it was something
my [loved ones] really needed to
hear,” he said. “I was given a lot
of information about what to
expect, and I made an extremely
informed decision. But if I had to
make one suggestion for nurses,
live-donor transplantation for it would be to provide potential
the kidney and liver program at living donors with talking points
Montefiore Medical Center in for their families and friends. I
Bronx, New York, for more than think it would have helped a lot
15 years. Given that the waiting to have gone home and explained
time for kidneys is five to seven things better to those who were
years and that there are approxi­ worried about my decision.”
mately 85,000 names on the —Bethany Lyttle
U.S. waiting list, advocates of
live-donor kidney transplantation Segev DL, et al. JAMA 2010;303(10):959-66.
NewsCAP
NewsCAP
Potentially inappropriate medication in EDs. A study in the March
issue of Academic Emergency Medicine estimated that 19.5 million pa­
tients ages 65 and older were given at least one potentially inappro-
priate medication during ED visits between 2000 and 2006. Groups
more likely to receive potentially inappropriate medications were
women 65 to 74 years of age, patients with nonurgent complaints,
those receiving two or more medications, those in rural areas not in the
Northeast, and patients in for-profit hospitals. To reduce the number of
errors, the authors recommend eliminating the use of particular drugs
in the ED; many commonly used potentially inappropriate drugs were
antihistamines, antihypertensives, narcotics, and antiinflammatory
agents. Two medications—promethazine and ketorolac— accounted
for 40% of the events. They also suggest using safety measures like
computer reviews and informing practitioners about the Beers criteria
(a list of medications generally considered inappropriate for use in
elderly patients). t