title: Urologic Disorders in Living Renal Donors and Outcomes of Their Recipients.
abstract: BACKGROUND
  There is an expanding gap between the number of patients listed for kidney transplantation and the number of kidney transplantations performed annually. The use of sensitive imaging methods results in increased discovery of many urologic asymptomatic problems, such as urolithiases, renal cysts, and solid renal masses. This result has brought the question of whether all donors with these urologic disorders should be rejected for donation.
  
  
  METHODS
  We retrospectively analyzed donor and recipient records of all living kidney transplantations performed from 2004 to 2014.
  
  
  RESULTS
  Among 251 living-related donor kidney transplantations, 51 donors (20.3%) had urologic disorders. Mean donor age was significantly higher in donors with urologic disorders than in the standard donor group (50 y vs 41 y). The identified disorders were 32 renal cysts, 8 urolithiases, 3 renal tumors, 6 adrenal adenomas, and 2 microscopic hematurias. After nephrectomy, the graft kidneys with cysts were inspected carefully and all of the cortical-peripheral cysts were decorticated. Renal tumors were excised in 3 renal units. Transplantations had proceeded after the confirmation of low malignancy potentials of the lesions with safe surgical margins. Two out of 8 patients had undergone stone removal with ex vivo ureteroscopy and 1 by means of pyelotomy incision because of calix neck stenosis. None of those donors and recipients developed clinically significant renal stone disease with a mean follow-up of 28 months. Neither donors nor recipients of asymptomatic microscopic hematuria patients developed any problem with a mean 28 months' follow-up period.
  
  
  CONCLUSIONS
  Asymptomatic urologic problems are very common. The significance of these asymptomatic pathologies is unclear. Our results suggest that in a selected group, at least some of these candidates can be accepted for donation.
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Tonyali
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Erdem
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: S R
authors.initials: SR
authors.lastname: Yilmaz
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Erkan
authors.affiliation: Department of Urology, Hacettepe University School of Medicine, Ankara, Turkey. Electronic address: ftuncayaki@yahoo.com.
authors.forename: F T
authors.initials: FT
authors.lastname: Aki
mesh_terms: D000328:Adult; D046148:Donor Selection / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D014570:Urologic Diseases / Q000453:epidemiology* / Q000473:pathology