Social trends of living renal donors in Libya

Purpose: To assess the epidemiological patterns and social trends in our living related renal donors pool .. Materials & Methods: 461 living related renal donors were evaluated from August, 2004 till January, 2010. Their records and operative notes were retrospectively analyzed for (1) operated or not (2) type of pre-operative angiography (3) right or left nephrectomy (4) laparoscopic or open nephrectomy (5) age and sex (6) relationship with the recipient. The reasons for donors who were not operated were analyzed. Statistical analysis was performed using SPSS software.. Results: A total of 461 living related donors were included in the study out of which 266 (57.7%) were operated. There were 381 males (82.6%) and 80 females (17.4%) with age range 18-63 years (mean age 32.6 years). 434 (94.1%) donors underwent CT angiography while 27 (5.9%) underwent MR angiography. 224 (84.2%) underwent left nephrectomy out of which 216 (81.2%) underwent open nephrectomy and 8 (3%) underwent laparoscopic nephrectomy. Rest all 42 (15.8%) donors underwent open right nephrectomy. 195 donors (42.3%) were not selected for donation. Difficult renal vascular anatomy was the main reason for non-selection seen in 95% donors. There were 13 (4.9%) teenaged donors while there were 24 (9%) elderly (>= 50 years) donors. Most of the donors were in the age range 20-39 (71.4%). Majority of the female donors were in the age range 20-29 years (n =28; 35%) followed by 22 (27.5%) in the age range 40-49 years. The most common donor recipient relationship was sibling - sibling (n = 157; 59.1%) with male:female ratio = 2.6:1. There were 81 (30.5%) of brother-to-brother donation while just 18 (6.8%) of sister-to-sister donation. 15% of the cases involved parent-to-child donation while 22.2% were child-to-parent donation. There was higher (17.3%) incidence of son donating to parent as compared to daughter (4.9%). Higher incidence (39.9%) was also seen in the instance of a sibling donating to a brother as compared to sister (19.2%). Mother-to-child donation was more common (9.4%) as compared to father-to-child (5.6%). There was almost equal incidence of a child donating either to father (11.6%) or mother (10.6%). Wife-to-husband donation (n = 4; 1.5%) was double than husband-to-wife donation and niece-to-uncle donation (n = 3; 1.1%) was three times vice-a-versa .. Conclusion: There was preponderance of male donations with peak age range 20-39 years with highest incidence of sibling-to-sibling donation. CT angiography was the preferred diagnostic tool for pre-operative planning and left open nephrectomy was the preferred surgical technique in our transplant program.