Kidney Donor Candidates May Have Various Incidentally Detected Lesions

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In a study, multidetector CT donor assessment revealed a variety of incidentally detected lesions of moderate or high importance among kidney donor candidates.
In a study, multidetector CT donor assessment revealed a variety of incidentally detected lesions of moderate or high importance among kidney donor candidates.

Potential living kidney donors have a number of different incidentally detected lesions found when they undergo multidetector computed tomography (MDCT) during donor assessment, a new study found.

“Our main finding is that a variety of incidentally detected lesions of moderate to high importance were detected in the liver, kidney, pancreas, lung, reproductive organs, and gastrointestinal systems in this healthy subject cohort,” Damien C. O'Neill, MD, and collaborators at Beaumont Hospital in Dublin, Ireland, reported in Experimental and Clinical Transplantation.

In a study of 375 potential living kidney donors—of whom 193 (51%) proceeded to donation—MDCT revealed 228 incidental findings among 158 individuals. Of the 228 incidental findings, 97 were in the donor cohort and 131 were in the cohort that did not proceed to donation. The most common findings were Bosniak 1 renal cysts (46 cysts), followed by liver cysts (42 cysts less than 1.5 cm) and urinary tract calculi (21 calculi).  One incidentally detected pathologically proven malignancy was found.

“Potential donors undergoing assessment with MDCT for living donor nephrectomy should be counseled on the medical implications of incidentally detected lesions during the assessment process,” the authors concluded.

In a study published earlier this year in Clinical Transplantation, Arika L. Hoffman, MD, and colleagues at the University of Nebraska Medical Center in Omaha reported on a study showing that 65 (8.5%) of 762 potential living kidney donor candidates were disqualified from donating a kidney because of a newly diagnosed serious medical condition discovered during their evaluation. The group included 6 patients diagnosed with malignancies (5 of whom required surgery), 6 with transmittable diseases requiring follow-up and treatment, 4 with bilateral renal stones with significant stone burden, and 2 diagnosed with IgA nephropathy. In addition, 4 patients were diagnosed with significant heart disease.

Reference

O'Neill DC, Davis NF, Murray TE, et al. Prevalence of incidental findings on multidetector computed tomography in potential nephrectomy donors: A prospective observational study.Exp Clin Transplant. 2018; published online ahead of print.

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