Donor Long-Term Follow-Up Study: Recent Publications
Your completed surveys contribute to an active ongoing effort to determine long-term outcomes after kidney donation. Our goal is to inform acceptance criteria for donation, identify any long-term risks associated with donation, and provide information for informed consent for donor candidates.
Some of our recent publications are listed below by topic. There is also a brief description of the purpose of the study and the findings.
Publications Since 2018
Review Articles on Donor Risks
- Long-term Medical Outcomes of Living Kidney Donors. Authors: Matas AJ, Rule AD. Mayo Clinic Proceedings. 2022. A review of existing knowledge of long-term risks
- Living Kidney Donation: A Narrative Review of Mid- and Long-term Psychosocial Outcomes. Authors: Massey EK, Rule AD, Matas AJ. Transplantation. 2025 Feb 1;109(2):259-272. doi: 10.1097. Epub 2024 Jun 18. PMID: 38886889 A review of existing knowledge of mid- and long-term psychosocial risks
- Living Donation and Pregnancy-Related Complications: State of the Evidence and Call To Action for Improved Risk Assessment. Authors Rossi AP, Katz-Greenberg G, Coscia L, et al, Clin J Am Soc Nephrol, 19:1659-1670, 2024
Studies to Identify Donor Risks
- The Minnesota attributable risk of kidney donation (MARKD) study: a retrospective cohort study of long-term (>50 year) outcomes after kidney donation compared to well-matched healthy controls. Authors: Vock DM, Helgeson ES, Mullan AF, et al. BioMed Central Nephrology. 2023. The major problem in studying long-term donor risks is identifying a group who is healthy (and would meet criteria for donor acceptance) and that has subsequently been followed for a long interval. This article describes our current work with the Mayo Clinic to identify healthy controls with the same characteristics as the donors and followed for a long time. Results should be available in 2026.
- Kidney donor outcomes ≥ 50 years after donation. Authors: Keys DO, Jackson S, Berglund D, et al. Clinical Transplantation. 2019. We describe outcomes of those donating a kidney over 50 years ago.
- Fracture Risk Among Living Kidney Donors 25 Years After Donation. Authors: Maradit Kremers H, Grossardt BR, Miller AR. AMA Netw Open. 2024 Jan 2;7(1):e2353005. doi: 10.1001/jamanetworkopen.2023.53005.PMID: 38265798 A study of donors at the University, Mayo Clinic, and Hennepin county Medical Centers found no increase risk of fractures.
- Grossardt BR, Maradit Kremers H, Miller AR, Kasiske BL, Matas AJ, Khosla S, Kremers WK, Amer H, Kumar R. Persistent changes in calcium-regulating hormones and bone turnover markers in living kidney donors more than 20 years after donation. JBMR Plus. 2024 May 13;8(7):ziae067. doi: 10.1093/jbmrpl/ziae067. PMID: 38868597; PMCID: PMC11166890.
- Evans MD, Helgeson ES, Rule AD, Vock DM, Matas AJ. Consequences of low estimated glomerular filtration rate either before or early after kidney donation. Am J Transplant. 2024 Oct;24(10):1816-1827. doi: 10.1016/j.ajt.2024.04.023. Epub 2024 Jun 14. PMID: 38878866; PMCID: PMC11439579.
Development of Risk Calculators That Can Be Used at the Time of Donor Evaluation
Using information provided in the medical record and in our surveys, we studied the impact of donor characteristics at the time of donation (e.g. weight, family history), and have developed a calculator to provide donor candidates an estimate of their long-term risks after donation. Importantly, these risks may be due to individual characteristics and not a result of donation.
- Development and Validation of a Hypertension Risk Calculator for Living Kidney Donors. Authors: Helgeson ES, Vempati S, Palzer EF, et al. Transplantation. 2023.
- Long-Term Living Kidney Donor Risk: A Web-Based Calculator. Authors: Palzer EF, Vempati S, Helgeson ES, et al. Journal of the American Society of Nephrology. 2020.
Pregnancy
In the general population, gestational hypertension, preeclampsia, eclampsia and gestational diabetes are associated with long-term risks (e.g., hypertension, diabetes, cardiovascular disease). We found that the same risks exist in donors, but are similar or less than seen in the general population.
- Pre-kidney Donation Pregnancy Complications and Long-term Outcomes. Authors: Helgeson ES, Palzer EF, Vock DM, et al. Transplantation. 2022.
- Long-term Outcomes Associated With Post-kidney Donation Pregnancy Complications. Authors: Palzer EF, Helgeson ES, Evans MD, et al. Transplantation. 2023.
Kidney Function and Kidney Failure
There has been concern that after donation, kidney function will decrease leading to chronic kidney disease. In these articles, we show that kidney function improves a small amount each year after donation for as long as 20 years. We also show that donors who develop kidney disease usually have a specific cause of their kidney disease. In addition, we show that most of those who develop kidney disease are related to the recipient. It has been shown that relatives of those with kidney disease have increased risk of kidney disease.
- Measured Glomerular Filtration Rate After Kidney Donation: No Evidence of Accelerated Decay. Authors: Berglund DM, Zhang L, Matas AJ, et al. Transplantation. 2018.
- GFR ≤25 years postdonation in living kidney donors with (vs. without) a first-degree relative with ESRD. Authors: Matas AJ, Vock DM, Ibrahim HN. American Journal of
Transplantation. 2018. - Causes and timing of end-stage renal disease after living kidney donation. Authors: Matas AJ, Berglund DM, Vock DM, et al. American Journal of Transplantation. 2018.
Nondirected Donation
- Long-term psychosocial outcomes after nondirected donation: A single-center experience. Authors: Jacobs C, Berglund DM, Wiseman JF, et al. American Journal of Transplantation. 2019. We show that psychosocial outcomes after nondirected donation (a donor who donates to anyone on the waiting list and often never meets the recipient) are similar to donors who know their recipient.
Donor Selection
- Age alone is not a contraindication to kidney donation: Outcomes of donor nephrectomy in the elderly. Authors: Serrano OK, Yadav K, Bangdiwala A, et al. Clinical
Transplantation. 2018. Donation by selected donors over the age of 60 poses minimal perioperative risks and no added risk of long-term kidney failure. - Outcomes of Kidney Donors With Impaired Fasting Glucose. Authors: Hebert SA, Murad DN, Nguyen DT, et al. Transplantation. 2022. Donors with pre-diabetes (blood glucose <126) did not have increased risks after donation.
- Implications of excess weight on kidney donation: Long-term consequences of donor nephrectomy in obese donors. Authors: Serrano OK, Sengupta B, Bangdiwala A, et al. Surgery. 2018. Donors with BMI >30 were more likely to develop hypertension and/or diabetes.
Donor Complications
- Orchialgia After Living Donor Nephrectomy: An Underreported Entity. Authors: Schoephoerster J, Matas A, Jackson S, et al. Transplant Direct. 2022. We surveyed male donors and found that short-term testicular pain and swelling is not unusual after donation.
- Weight gain after kidney donation: Association with increased risks of type 2 diabetes and hypertension. Authors: Issa N, Sánchez OA, Kukla A, et al. Clinical Transplantation. 2018.
Psychosocial Concerns
- Psychosocial Impact of Being Denied as a Living Kidney Donor. Authors: Calkins F, Matar AJ, Megaly MG, et al, Transplant Proc. 2025 Oct;57(8):1627-1634. doi: 10.1016/j.transproceed.2025.09.007. Epub 2025 Sep 16. PMID: 40962671.
Donor Evaluation
- Holzner ML, Matas A, Park SC, Langas A, Hoffman A, Heyne N, Guthoff M, Flechner S, Shapiro R. The Life-Saving Benefit of the Living Donor Kidney Evaluation: A Mini Review. Clin Transplant. 2025 Aug;39(8):e70253. doi: 10.1111/ctr.70253. PMID: 40698571.