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Evaluation of Deceased Kidney Donors for Renal Stone Disease: Is Computed Tomography Needed?
Senol Tonyali1, Ahmet M Aydin2
1Department of Urology, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey.
Objective:
To investigate the clinical consequences of neglected risk of urolithiasis in deceased kidney donors in routine clinical practice, this study focused on different management options for transplanted allograft stones, and tried to find new solutions for more accurate detection of urolithiasis in deceased kidney donors prior to renal transplantation.
Methods And Results:
The overall prevalence of stone disease in endemic countries is between 7 and 29%. Because of the increased risk for stone disease in epidemic countries, screening renal grafts from deceased donors necessitates more sensitive imaging tests. Despite well established procedures on preoperative living related renal donor evaluation, there is no consensus on a preoperative imaging tool in cadaveric renal donor evaluation. The most commonly used imaging modality in deceased renal donors is ultrasonography. The overall sensitivity and specificity of ultrasonography for kidney stones are 45 and 88%, respectively. Use of a computed tomography scan for renal diseases, especially for urinary stones is now almost a routine test in clinical practice. Its sensitivity for renal stones < 3 mm is 85%, whereas for renal stones > 3 mm it is 100%.
Conclusion:
The use of radiological modalities i.e. computed tomography with higher sensitivity in deceased donors prior to renal transplantation seems reasonable in urinary stone epidemic countries.
Insights
Detecting kidney stones in deceased organ donors is crucial. Computed tomography scans offer higher sensitivity than ultrasound for identifying urolithiasis before kidney transplantation, especially in stone-prone regions.
Area of Science:
- Nephrology
- Urology
- Radiology
Background:
- Urolithiasis poses a risk in kidney donors.
- Screening deceased donors for kidney stones is essential to prevent allograft complications.
- Current preoperative imaging lacks consensus for cadaveric donors.
Purpose of the Study:
- Investigate clinical outcomes of neglected urolithiasis in deceased kidney donors.
- Evaluate management of allograft stones.
- Identify improved detection methods for urolithiasis in deceased donors pre-transplant.
Main Methods:
- Review of clinical practices and imaging modalities for deceased kidney donor evaluation.
- Comparison of ultrasonography and computed tomography (CT) for detecting kidney stones.
- Analysis of sensitivity and specificity of imaging techniques.
Main Results:
- Ultrasonography sensitivity for kidney stones is 45%, specificity 88%.
- CT scan sensitivity is 85% for stones < 3 mm and 100% for stones > 3 mm.
- Stone disease prevalence ranges from 7-29% in endemic areas.
Conclusions:
- Computed tomography demonstrates superior sensitivity for detecting kidney stones in deceased donors.
- Enhanced imaging is necessary for screening renal grafts in stone-prevalent regions.
- CT is a valuable tool for identifying urolithiasis prior to renal transplantation in epidemic countries.
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