THE USE OF KIDNEYS FROM LIVING DONORS WITH RENAL VASCULAR-DISEASE - EXPANDING THE DONOR POOL

Purpose: The disparity between the number of patients awaiting organ t ransplantation and the number of available donor organs continues to i ncrease. We report the outcomes of transplantation using kidneys from living donors who had unilateral renovascular disease. Materials and M ethods: We identified 5 living donors who had unilateral renovascular disease, including saccular renal artery aneurysms, an arteriovenous m alformation, localized atherosclerosis and fibromuscular renal artery stenosis. Each donor was normotensive and asymptomatic, and had otherw ise normal renal function. Results: In each case the abnormal kidney w as removed, the lesion was repaired ex vivo and the kidney was success fully transplanted without complication in the donor or recipient. Eac h recipient had a serum creatinine of less than 2 mg./dl. and each don or remained normotensive with stable renal function at up to 3 years o f followup. Conclusions: Kidneys from living donors with renovascular disease can be transplanted safely provided that careful selection, in formed consent and a normal remaining kidney are ensured.