Living renal donor allograft lithiasis: a review of stone related morbidity in donors and recipients.
OBJECTIVE
The use of screening computerized tomography angiography has resulted in the increased detection of incidental nephrolithiasis in potential living renal donor candidates. We reviewed current acceptance guidelines for donors with stone disease as well as data on stone related outcomes in donors with stone disease and recipients who received a kidney with a stone left in situ.


METHODS
We performed a medical literature search in English using MEDLINE/PubMed that addressed renal donor allograft lithiasis. We then analyzed the literature with respect to the historical evolution of this concept, current guidelines regarding the acceptance of donors with stones and stone related morbidity in recipients and donors.


RESULTS
The prevalence of asymptomatic solitary nephrolithiasis has increased with the widespread use of screening computerized tomography angiography during renal donor evaluation. Few studies have addressed the risk of stone related morbidity in donors and recipients. Short-term studies have shown little stone related morbidity in patients who donate or receive an allograft with a stone left in situ. Consensus statements from transplant societies around the world offer guidance for determining donor eligibility.


CONCLUSIONS
The available literature on stone related morbidity in donors and recipients is extremely limited. It would appear that the risk of recurrence and subsequent morbidity in renal donors with a solitary kidney is low but not insignificant. Rare stone related adverse events are reported for recipients of an allograft with a stone left in situ. Renal donors and recipients should be educated regarding their unique risk perspectives. Long-term followup is mandatory.
Strang
Andrew M
AM
Division of Urology, University of Alabama at Birmingham, Birmingham, Alabama 35294-3411, USA. strang88@hotmail.com
Lockhart
Mark E
ME
Amling
Christopher L
CL
Kolettis
Peter N
PN
Burns
John R
JR
D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011859:Radiography; D014184:Transplantation, Homologous