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Updated: Nov 10, 2025
Mouse Kidney Transplantation: Models of Allograft Rejection
Published on: October 11, 2014
Considerations for utilizing medullary sponge kidney allografts in pediatric patients
Ruchi G Mahajan1, Jae-Hyung Chang2, Brian Runge3
1Division of Pediatric Nephrology, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
Background:
Medullary sponge kidney (MSK) disease predisposes patients to recurrent nephrolithiasis, which affects one in every 5000 people in the United States.
Methods:
We report a rare case of a pediatric recipient of a living donor MSK transplant and discuss considerations when discussing risks and benefits of accepting MSK allografts for this population.
Results:
The recipient was admitted due to concerns for nephrolithiasis, hydronephrosis, and urinary tract infection at 1-month post-transplant. The hydronephrosis was resolved by surgical removal of an encrusted ureteral stent; this was followed by supplementation with oral medications to prevent future episodes of nephrolithiasis. The recipient did not have any further episodes after this as seen at a 1-year follow-up. The donor has remained well through this period.
Conclusions:
With increasing organ shortages, the use of variety of donors may need to be considered to enlarge the organ pool.
Insights
Medullary sponge kidney (MSK) disease can lead to kidney stones. This case study explores the successful kidney transplant of a pediatric patient with MSK, highlighting donor considerations.
Area of Science:
- Nephrology
- Transplantation
- Urology
Background:
- Medullary sponge kidney (MSK) disease is a congenital renal abnormality associated with recurrent nephrolithiasis.
- MSK disease affects approximately 1 in 5000 individuals in the United States, posing a significant risk for kidney stone formation.
- Recurrent nephrolithiasis in MSK disease can lead to graft dysfunction and failure.
Observation:
- A pediatric patient with MSK disease underwent a living donor kidney transplant.
- Post-transplant complications included nephrolithiasis, hydronephrosis, and urinary tract infection at one month.
- Surgical intervention for an encrusted ureteral stent resolved hydronephrosis.
Findings:
- The pediatric recipient experienced resolution of hydronephrosis after stent removal.
- Oral medication prophylaxis successfully prevented further nephrolithiasis episodes.
- The patient remained free of nephrolithiasis at one-year follow-up, with the donor remaining in good health.
Implications:
- This case demonstrates the feasibility of kidney transplantation in pediatric patients with MSK disease.
- Careful management of post-transplant complications, such as nephrolithiasis and hydronephrosis, is crucial for graft survival.
- Expanding the donor pool to include living donors with conditions like MSK may be necessary given organ shortages.
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