Calculus bearing live donor kidneys for renal transplantaion. Is it a viable option?

Aim: To evaluate the outcome of using potential donor kidneys with asymptomatic calculi detected during screening with specific reference to the pre operative work up and the management of the calculus prior to, during and after transplantation. Materials and Methods: Ten live related donors, detected to have a single incidentally detected calculus, during their routine work up, were accepted for transplantation from 2002 to 2006. There was no biochemical evidence of metabolic abnormality or history of stone disease. Four donor kidneys underwent elective shock wave lithotripsy and in one, nephrolithotomy was carried out under ultrasound control after perfusion. The others were transplanted with the calculus in-situ. Ureteric reimplantation was carried out over a double J stent. Results: One calculus was passed out soon after stent removal. The follow up imaging showed the calculus in only one. In the others, the stone could not be visualized after stent removal. The maximum follow up was 60 months for donor and recipients. The graft function has remained normal in eight and no donor has developed recurrence of calculus. Conclusions: Voluntary kidney donors with a single calculus incidentally detected on routine evaluation, form a unique group and can be accepted for transplantation in highly selected cases. Careful follow-up of the donor and recipient is essential with early intervention if necessary. [ABSTRACT FROM AUTHOR]