Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Transplant. Aug 18, 2020; 10(8): 215-222
Published online Aug 18, 2020. doi: 10.5500/wjt.v10.i8.215
Unspecified live kidney donation by urological patients
Sebastiaan Ceuppens, Hendrikus J A N Kimenai, Karel W J Klop, Willij C Zuidema, Michiel G H Betjes, Willem Weimar, Jan N M IJzermans, Frank J M F Dor, Robert C Minnee
Sebastiaan Ceuppens, Hendrikus J A N Kimenai, Karel W J Klop, Jan N M IJzermans, Robert C Minnee, Division of Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Rotterdam 3015GD, Netherlands
Willij C Zuidema, Michiel G H Betjes, Willem Weimar, Department of Internal Medicine, Nephrology and Kidney Transplant Unit, Rotterdam 3000CA, Netherlands
Frank J M F Dor, Imperial College Renal and Transplant Unit, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London W12 0HS, United Kingdom
Author contributions: Ceuppens S was involved in writing the manuscript, participated in the investigation, data validation, reviewing and editing of the manuscript; Kimenai HJAN was involved in writing the first draft, collecting the data and reviewing the manuscript; Klop KWJ was involved in reviewing the manuscript; Zuidema WC was involved in data curation and reviewing the manuscript; Betjes MGH, Weimar W and Ijzermans JNM were involved in reviewing the manuscript; Dor FJMF was involved in the study conceptualization and reviewed the manuscript; Minnee RC took part in the supervision of the study and was involved in reviewing and editing the manuscript.
Institutional review board statement: The daily board of the medical ethics committee Erasmus MC of Rotterdam, The Netherlands reviewed the above-mentioned research proposal.
Informed consent statement: As our committee informed you that the rules laid down in the Medical Research lnvolving Human Subjects Act, do not apply to this research proposal, we do not have to ask our patients for informed written consent.
Conflict-of-interest statement: The authors declare no funding and no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Robert C Minnee, FEBS, MD, PhD, Assistant Professor, Senior Researcher, Surgeon, Division of Transplant Surgery, Department of Surgery, Erasmus MC University Medical Center, Molewaterplein 40, Rotterdam 3015GD, Netherlands. r.minnee@erasmusmc.nl
Received: February 5, 2020
Peer-review started: February 5, 2020
First decision: April 1, 2020
Revised: June 29, 2020
Accepted: July 1, 2020
Article in press: July 1, 2020
Published online: August 18, 2020
Processing time: 183 Days and 18.7 Hours
Abstract
BACKGROUND

Individuals with benign kidney disorders undergoing nephrectomy have three possibilities: Autotransplantation, with a certain risk of complications, but without a clear benefit; discarding the kidney; or living kidney donation.

AIM

To investigate whether patients with benign kidney disorders and a medical indication for nephrectomy are suitable as unspecified live kidney donors.

METHODS

We searched all clinical data from 1994-2019 for unspecified donors and their transplant recipients (n = 160). Nine of these 160 donors had pre-existing kidney disorders necessitating nephrectomy and had decided to donate their kidney anonymously after discussing the possibility of kidney donation. We studied the clinical course of these nine donating patients and their transplant recipients.

RESULTS

Seven of nine donating patients indicated unbearable loin pain as the main complaint, one donating patient refused ureterocutaneostomy and one had two aneurysms of the renal artery. Postoperatively, seven donating patients described absence of pain and one a significant reduction after the nephrectomy. The average 1-year creatinine level in the donating patients was 88 µmol/L and after a median of 6.9 years the average creatinine level was 86.6 µmol/L. In the transplant recipients, one major complication occurred which led to death and in one transplant recipient graft function failed to normalize at first but has been stable for nine years now. Currently, all transplant recipients are off dialysis.

CONCLUSION

Our data show that patients undergoing nephrectomy as part of treatment in selected kidney disorders can function as live kidney donors.

Keywords: Unspecified donor; Live kidney donation; Benign kidney disorder; Living donors; Kidney; Transplantation

Core tip: The aim of this study was to investigate if a kidney after nephrectomy in patients with a benign kidney disorder could be transplanted successfully as an unspecified live donor kidney transplant. Follow-up showed that the 1-year average creatinine level was 88 µmol/L and after a median of 6.9 years an average creatinine level of 86.6 µmol/L was reached in these donating patients. In seven of nine donating patients the absence of pain was described. Transplant recipients showed an average creatinine level of 164.5 µmol/L with a median follow-up of 7.7 years. Furthermore, all transplant recipients are currently not on dialysis. Our data show the safety and feasibility of transplanting kidneys from patients with a medical indication for nephrectomy and enlarging the live kidney donor pool.