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[Renal, vascular and urological variations and abnormalities in living kidney donor candidates]
Insights
A high prevalence of renal anatomical variations and acquired pathologies exist in living kidney donor candidates. However, most variations do not contraindicate donation, allowing many candidates to proceed.
Area of Science:
- Nephrology
- Urology
- Radiology
Background:
- Living kidney donor candidates (LKDC) undergo evaluation for renal anatomic variations and acquired pathologies.
- Understanding the prevalence of these conditions is crucial for donor safety and successful transplantation.
Purpose of the Study:
- To determine the prevalence of anatomical variations (renal, vascular, urological) and acquired renal pathologies in LKDC.
- To assess the impact of these findings on donor eligibility.
Main Methods:
- Retrospective analysis of 491 LKDC referred between April 2003 and September 2014.
- 302 candidates underwent radiological assessment (angio-CT or MRI).
- Data collected on anatomical variations and acquired renal pathologies.
Main Results:
- 58.9% of LKDC (178/302) had one or more anatomical variations or acquired abnormalities.
- Arterial variations/abnormalities were most frequent (39.3%), followed by venous abnormalities (27.8%).
- Kidney stones (5.6%) and urinary abnormalities (3%) were also observed; 1.3% had benign tumors.
Conclusions:
- A high prevalence of anatomical variations and acquired abnormalities exists in LKDC.
- These findings excluded only 4% of candidates, as they often do not contraindicate donation.
- The contralateral kidney can frequently be used, preserving donation potential.
Introduction:
The aim of this study was to determine the prevalence of anatomic variations (renal, vascular and urological) and acquired renal pathologies in living kidney donor candidates (LKDC).
Methods:
This is a retrospective study of all LKDC referred to our center between April 2003 and September 2014. Of the 491 LKDC, 189 were initially excluded for medical reasons (n=140) or others reasons (n=49), without undergoing a radiological assessment. In total, 302 had a radiological assessment (angio-CT or MRI) in anticipation of the donation and 226/302 (73.5%) could donate a kidney.
Results:
One or more anatomical variations and/or acquired abnormalities were observed in 178/302 (58.9%) of the LKDC. The most frequent were arterial variations or abnormalities (multiple arteries, fibrodysplasia, aneurysms, stenosis≥70%) which where observed in 39.3% of the LKDC, followed by the venous abnormalities (27.8%). Kidney stones were observed in 5.6% of the LKDC and the urinary abnormalities (duplication/ureteral bifidity) were found in 3% of the LKDC. No malignant tumour was diagnosed, while 4 benign tumours (1.3%) were identified, and one of them required additional investigations.
Conclusion:
We found a high prevalence of anatomical variations and acquired abnormalities in a population of LKDC. However, these findings resulted in the exclusion of only 4% of the candidates, because they did not contraindicate the donation or, in most of cases, the contralateral kidney could be used.
Level Of Evidence:
3.
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