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
ARTICLE HIGHLIGHTS
Research background

Currently patients with benign kidney disorder who undergo nephrectomy have three options: Autotransplantation (AutoTx), discarding the kidney or living kidney donation. This study investigates whether a kidney after nephrectomy in patients with benign kidney disorders can be transplanted successfully as an unspecified live kidney donor.

Research motivation

AutoTx of these kidneys adds an additional surgical procedure with higher intraoperative complication rates and morbidity. We investigated the transplant outcome and outcome of these unspecified live kidney donors. If these kidneys can be successfully used in live kidney donation, the donor pool can be enlarged.

Research objectives

The main objective was to investigate whether patients with benign kidney disorders and a medical indication for nephrectomy are suitable donors as unspecified live kidney donors. This may lead to good functioning kidneys which otherwise may have been discarded or autotransplanted, with additional risks.

Research methods

We searched our centre database for unspecified kidney donations and their recipients. Donors with pre-existing kidney disorders necessitating nephrectomy were followed up and their clinical course was studied.

Research results

We present a new way of expanding the donor pool with a new type of living kidney donation, which provided excellent renal outcomes for the donors and the recipients.

Research conclusions

Kidneys retrieved after nephrectomy from unspecified donors with urological complications are excellent donor kidneys. Long-term follow-up shows that these kidneys provide a safe and feasible option for enlarging the kidney donor pool. We are the first group to present this type of cohort. Kidneys which would have been discarded or otherwise autotransplanted due to urological complications should be investigated to determine if they can be used as donor kidneys.

Research perspectives

When nephrectomy is suggested in patients with benign kidney disorders, these kidneys should be carefully examined to determine whether they can function as kidney donors. Future research should confirm these findings with a larger cohort.