Schistosomiasis and renal transplantation

Schistosomiasis was discovered in 4 recipients and 12 donors during evaluation for 67 consecutive live related renal transplants. All participants with schistosomiasis were treated with anti-schistosomal chemotherapy preoperatively. No complications were seen in the 4 recipients, including 2 with schistosomal-induced calcifications of the bladder. One donor returned to an endemic area and became reinfected with slight progression of distal ureteral dilatation. Cystoscopy with biopsy is more sensitive in the detection of infection than ultrasonography, excretory urography or urinalysis but structural changes are assessed by excretory urography. Although schistosomiasis is not an absolute contraindication for renal transplantation, potential live kidney donors with proved anatomical changes in the urinary tract should be excluded.