Introduction: Historically patients wishing to donate their kidney to living related recipients were deemed ineligible if pre-operative imaging demonstrated nephrolithiasis.
We assess the outcomes of donors with nephrolithiasis and the outcomes of their recipients.
Methods: Donors undergoing nephrectomy between 2001-2011 who had nephrolithiasis on preoperative CT imaging or a history of stone passage were identified. A retrospective chart review documented donor and recipient demographics, donor 24-hour urine collections, stone size and location, stone events following transplant and graft function. A 7-question telephone survey regarding development and/or presence of symptomatic nephrolithiasis was conducted.
Results: 54 donor-recipient pairs met the inclusion criteria. Twenty-eight (51.9%) patients had valid pre-operative 24-hour urine collection, seven (25%) of which had hypercalciuria. Seven (13%) patients had previous symptomatic nephrolithiasis, but no stones on imaging. 41 patients donated a kidney with at least one stone, with a mean stone size of 2.4 mm (range 1-6 mm). Median follow-up for donors and recipients was 22.5 months [IQR 1 - 79.3] and 47.4 months [IQR 25.1 - 76.1], with 50% and 77.7% having a follow-up of more than two years, respectively. One donor with nephrolithiasis on pre-operative imaging who donated the contralateral kidney passed a stone spontaneously after visiting the emergency room. Otherwise, no other donors or recipients experienced any stone episodes during the follow-up period.
Conclusion: The risk of clinical stone recurrence in donors and recipients is low: as such, presence of small caliceal stones should not constitute an exclusion for living-related kidney donation.
Written by:
Rizkala E, Coleman S, Tran C, Isac W, Flechner SM, Goldfarb D, Monga M. Are you the author?
Cleveland Clinic Foundation, Glickman Urological and Kidney Institute, Cleveland, Ohio, United States.
Reference: J Endourol. 2013 Sep 2. Epub ahead of print.
doi: 10.1089/end.2013-0203.ECC13
PubMed Abstract
PMID: 23998720
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