V1726: Expanding the Kidney Organ Donor Pool and Reducing Patient Wait List Times Through Utilization of Living Donor Kidneys with Renal Angiomyolipomas
VideoIntroduction and Objectives
To document the appropriateness of using angiomyolipoma living donor kidneys for transplantation. The deficiency of adequate deceased kidney donors as well as known improved outcomes using living kidney donors have led to attempts to expand the kidney donor pool using living donors for transplantation. This includes utilization of kidneys previously not considered suitable for transplantation, including living donor kidneys with benign lesions such as renal angiomyolipoma. We present the case of a donor kidney with renal angiomyolipoma which was excised ex-vivo and transplanted successfully. Such expansion of the kidney donor pool serves to especially benefit patients who often waiting considerably longer waiting times on kidney donor lists, such as African Americans and highly sensitized patients.
Laparoscopic-hand assisted living donor nephrectomy of the left donor kidney known to harbor a 2.6 centimeter angiomyolipoma in the posterior midzone, in a patient with no other general manifestations of tuberous sclerosis, was performed. Ex- vivo partial nephrectomy of the angiomyolipoma was performed and subsequently the kidney was transplanted into the recipient. The recipient had given informed consent regarding the angiomyolipoma. The ex-vivo surgical resection technique and post implantation video will be presented.
The patient had no intra or post-operative bleeding or other complications. The kidney demonstrated immediate post-operative graft function with clearance. The patient was discharged on post-operative day five with a serum creatinine of 1.8 mg/dL.
The use of living donor kidneys containing benign lesions such as angiomyolipoma carries no increased detectable risk to the recipient and can help in expanding the kidney organ donor pool subsequently making more kidneys from deceased donors available to those patients who do not have living donors, thus decreasing patient wait list times.