Living Donor Gifted Lithiasis: Long-Term Outcomes in Recipients

Area of Science:

• Nephrology
• Transplantation Surgery
• Urology

Background:

• Nephrolithiasis in living kidney donors has historically been a contraindication for donation due to concerns about donor and recipient outcomes.
• Reluctance to utilize these donors stems from potential risks of stone recurrence and graft complications.

Purpose of the Study:

• To evaluate the long-term outcomes of kidney recipients whose living donors had a history of nephrolithiasis.
• To assess the safety and efficacy of kidney transplantation from donors with kidney stones.

Main Methods:

• Retrospective review of 57 donor-recipient pairs between 2003 and 2018.
• Donors had symptomatic kidney stones or imaging evidence of calculi.
• Recipient outcomes and graft function were monitored, including imaging studies.

Main Results:

• No recipients developed obstructing renal calculi or stone-related infections.
• No interventions were required for recurrent calculi in recipients.
• No stone episodes led to adverse graft events. Common donor risk factors included hyperoxaluria and hypercalciuria.

Conclusions:

• Kidney transplantation from living donors with nephrolithiasis is a safe procedure.
• Careful selection of donors with kidney stones, adhering to established guidelines, is crucial for successful outcomes.
• Further research is needed to develop consensus guidelines for utilizing these donors.