Medical evaluation of living kidney donors with nephrolithiasis: a survey of practices in the United States
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A scarcity of organs has driven the transplant community to broaden selection criteria for both living and deceased donors. Living donor transplants offer better patient and allograft survival when compared with deceased donor transplants. Many transplant centers now allow complex living donors such as those with nephrolithiasis to undergo nephrectomy.
We conducted a survey of medical and surgical directors of kidney transplant programs in the United States to shed light on current practices pertaining to medical evaluation of living kidney donors with nephrolithiasis. 353 surveys were e-mailed to medical directors and surgical directors of transplant programs after contacts were obtained from UNOS.
49 completed surveys were returned (13.9%). 77.7% (38/49) of survey participants said their centers will consider living kidney donor candidates with a history of symptomatic kidney stones, 69.4% (34/49) said their centers will consider candidates who are incidentally found to have kidney stones and 10.2% (5/49) said their centers decline all potential donors with nephrolithiasis.
Several programs are still reluctant to allow potential donors with nephrolithiasis to donate. There is an unmet need to develop evidence-based guidelines to optimize outcomes in this population of kidney donors with nephrolithiasis and their recipients.
KeywordsCalculi Renal Kidney transplantation Kidney donor Donor nephrectomy Nephrolithiasis Graft failure Living kidney donor Urolithiasis
Compliance with ethical standards
Conflict of interest
Dr. Goldfarb: consultant, Allena, Alnylam, AstraZeneca, Retrophin; owner, patent holder: Dr. Arnies. Mr. Modersitzki: consultant, Retrophin. Authors Vasishta S. Tatapudi, Silviana Marineci, and Michelle A. Josephson have declared that no conflict of interest exists.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee at New York University (NYU) Langone Health (IRB approval number s16-00224) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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