What is the Living Kidney Donor Safety Study?

The Living Kidney Donor (LKD) Safety Study is a multicenter prospective cohort study that looked at the long-term effects of becoming a kidney donor.  A total of 17 transplant centres across Canada and Australia recruited study participants. At these centres, the study team recruited living kidney donors, controls (study buddies) and recipients into the study. The trial was conducted to better understand:

• The long-term health outcomes of living kidney donors, including:
  • High blood pressure,
  • High levels of protein (or albumin) in the urine (albuminuria) and
  • Long-term kidney function (eGFR).
• The psychological effects of living kidney donation.
• The financial costs of living kidney donation evaluation.
• Living kidney donor factors which influence recipient outcomes.

The study’s primary findings were published in the Journal of the American Medical Association on May 23, 2024.

Why was this study needed?

A kidney transplant from a living donor is considered safe in healthy adults. Furthermore, it is the best treatment option for most patients with kidney failure. Receiving a kidney transplant from a living donor typically results in superior rates of graft survival and shorter wait times compared to a kidney transplant received from a deceased donor. Yet, the kidney transplant community, including donors, recipients, and potential donors, need to better understand the long-term effects of donation. 

The Study’s Methods

Between 2004 and 2014, the LKD Safety Study team recruited 1042 living donors (924 standard criteria donors and 118 donors with isolated medical abnormalities), 396 non-donor participants and 824 kidney recipients to participate in a study focused on determining the long-term outcomes for living kidney donors. Specifically, the study looked at the donor’s risk of developing high blood pressure or albuminuria, and the rate of kidney function decline in the decade following donation. The study also examined changes in the participants’ quality of life. This includes medical, financial, and psychological implications of living kidney donation.

During the study, the team collected annual blood pressure measurements, health and psycho-social questionnaires, and kidney function lab results from each participant, including initial baseline data in 2004 and 9576 annual follow-up visits held between 2005 to 2021. The study team analyzed the data with a focus on improving the transplant decision-making process, informed consent, health policies and the follow-up of living donors to keep them in good health.

The Living Kidney Donor Safety Study Findings

The LKD Safety Study collected data from participants for more than a decade. After completing the data analysis, the study team found that living donors have a similar risk of developing high blood pressure and albuminuria as non-donors. There is also no greater rate of kidney function decline after the initial drop and recovery of kidney function following surgery between donors and non-donors.

Specifically, high blood pressure occurred in 17% of donors and non-donors and the change in average blood pressure over a decade (median of 7.3 years) was similar between the groups. Additionally, donors reported lower physical health than non-donors in the first 3 months after surgery, but similar physical health in all follow-up annual questionnaires in subsequent years. The LKD Safety Study team found no other clinically relevant difference in health-related quality of life, anxiety, or depression during follow-up.

Read the team’s findings

Living Kidney Donor Safety Study Participating Centres