Patient-reported outcomes following living donor nephrectomy

Kidney transplantation is the optimal treatment for patients with end stage renal disease. In Norway almost 40 % of all renal transplants are performed with organs from living donors, and efforts are made to increase the number of kidneys available for transplantation. The purpose of this thesis was to study clinical and patient-reported outcomes following living kidney donor nephrectomy, with particular emphasis on patient-reported outcomes. A combination of quantitative and qualitative research approaches was used. In a randomized, controlled trial of 122 donors we compared laparoscopic and open donor nephrectomy, focusing on donor safety, postoperative pain, sick leave, health status and overall quality of life at 1, 6 and 12 months follow-up. To explore donor experiences of going through surgery 12 donors were in-depth interviewed at one week and at one year after open donor nephrectomy.

The results from the randomized trial demonstrated that the conventional open donor nephrectomy was superior to laparoscopic donor nephrectomy with regard to donor safety. Yet, an uncomplicated laparoscopic donor nephrectomy had important short-term advantages such as less analgesic requirements, less postoperative pain, shorter sick leave, and better health status and as compared to the open approach. Long-term follow up revealed significant differences in favour of laparoscopy only when adjusting for reoperations and convertions. We therefore conclude that long term benefits are hard to prove in favour of the laparoscopic technique. The in-depth interviews revealed that a positive feeling about being a donor was the dominant theme in both interview series. Though experiencing disincentives from surgery during the first postoperative period, the donors expressed that they were back to their normal health at one year after surgery. Donors experiencing unsuccessful recipient outcome did not regret donation.

Publications not indexed by PubMed:

Larsen MH, Hermansen Å, Borge CR, Strumse YS, Andersen MH & Wahl AK.
Health literacy profiling in persons with psoriasis – a cluster analysis.
Skin Health and Disease 2021

Larsen, MH, Strumse YSS, Borge CR, Andersen, MH, Wahl AK.
Viktige sammenhenger mellom aleksitymi og helsekompetanse hos pasienter med psoriasis som har deltatt i klimabehandling.
Best Practice Nordic 2020 (JUNI) p. -LDH LDS OUS UiO.

Haraldstad, Kristin; Wahl, Astrid Klopstad; Andenæs, Randi; Andersen, John Roger; Andersen, Marit Helen; Elisabeth Grov, Beisland; Råheim Borge, Christine; Engebretsen, Eivind; Eisemann, Martin; Halvorsrud, Liv Torill; Hanssen, Tove Aminda; Haugstvedt, Anne; Haugland, Trude; Johansen, Venke A; Løvereide, Lise; Larsen, Marie Hamilton; Løyland, Borghild; Kvarme, Lisbeth Gravdal; Moons, Philip; Norekvål, Tone M.; Ribu, Lis; Urstad, Kristin Hjorthaug; Rohde, Gudrun Elin; Helseth, Sølvi.
A systematic snapshot review of quality of life research in medicine and health sciences.
Internasjonal livskvalitetskonferanse, ISOQOL; 2018-10-24 - 2018-10-28.

Engebretsen, Eivind; Andersen, Marit Helen; Urstad, Kristin Hjorthaug; Wahl, Astrid Klopstad.
Action Research in Implementation and Evaluation. Outline of a Study of a Training Programme for Kidney Transplant Recipients. I: Theory and Methodology in International Comparative Classroom Studies.
Cappelen Damm Akademisk 2014 ISBN 978–82-02–47061–6. s. 256-266.

Foss, Aksel; Andersen, Marit Helen; Hagness, Morten; Vidnes, Tone Karine; Finstad, Ellen Drolsum; Wahl, Astrid Klopstad; Dueland, Svein.
Patient Survival and Quality of Life Following Liver Transplantation for Colorectal Liver Metastases.
Liver transplantation 2010 ;Volum 16.(6) s. S189-S190.

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