Are Renal Cysts a Barrier to Donation and Kidney Transplant?

We evaluated the long-term outcomes of kidney transplants performed using grafts that contain simple renal cysts, to determine whether these cysts constitute a barrier to kidney donation or transplant.

All kidney transplants performed by our team from February 2012 to May 2025 were retrospectively reviewed. Cases in which the graft contained at least 1 simple renal cyst were included. Demographic characteristics, cyst size, perioperative complications, postoperative renal function, and cyst size during follow-up ultrasonography were recorded. Postoperative serum creatinine levels were analyzed on day 1, week 1, month 1, and year 1. Changes in cyst size and the need for intervention were assessed.

A total of 66 kidney transplants involving grafts with simple cysts were included. The mean age of recipients was 50.2 years, and 38 were female recipients. The mean cyst diameter was 14.5 ± 8.3 mm. Eight (12.1%) grafts contained cysts smaller than 5 mm, 18 (27.3% )grafts had cysts between 5 and 10 mm, and 40 (60.6% )grafts had cysts larger than 10 mm. No intraoperative complications occurred in donors or recipients. Early postoperative urinary tract infection developed in 9 patients but resolved completely with intravenous antibiotic therapy. At postoperative month 6, 44 patients demonstrated a decrease in cyst size, whereas 15 patients showed an increase. Only 1 patient required surgical excision due to cyst enlargement exceeding 5 cm. Mean serum creatinine levels on postoperative day 1, week 1, month 1, and year 1 were 2.48, 1.42, 1.23, 1.42 mg/dL, respectively.

Simple cysts in kidney grafts do not constitute a contraindication to kidney donation or transplant. When managed in experienced transplant centers and followed regularly, grafts containing simple renal cysts demonstrate favorable outcomes with low complication rates.