ドナー提供の腎結石症：症例に基づく分析と比較研究

Donor-gifted nephrolithiasis-the presence of a stone in a donor kidney at the time of transplantation-is rare. Research is limited, and no consensus high-quality evidence guidelines exist, leaving selection criteria and management to individual provider discretion. We aimed to estimate the frequency and analyze patient and graft outcomes of deceased donor (DD) transplant recipients with stones in their kidneys at Wake Forest Baptist Medical Center.

All DD renal transplants or patients receiving most of their care postoperatively after DD renal transplantation at our institution from 1979 to 2025 were reviewed. Stones were considered donor-gifted if discovered during transplantation or on imaging within two weeks of the transplant date. Patient, stone, and graft outcomes were followed over time. Stone size on imaging was compared between patients who were treated versus surveyed for their donor-gifted stones using an independent samples t-test.

Of 4723 patients who underwent DD renal transplant, eight were found to have a graft with stones at transplant (0.2%). The median stone size was 8 mm. Three (38%) patients underwent treatment for stones, and five (62%) underwent surveillance. Two (25%) patients experienced graft failure, and one of these patients received stone treatment.

The frequency of donor-gifted nephrolithiasis is extremely low in DD transplant patients. Despite a small sample set, these results demonstrate favorable outcomes and provide support for the feasibility of intentionally performing DD renal transplantation in grafts with known stones.