Summary The number of potential organ donors depends on various factors, among which the number of deceased with primary or secondary brain damage is the most decisive. In the north‐east donor region of Germany with 7.69 million inhabitants, 2019 cases of deceased with primary or secondary brain damage were reported by 136 intensive care units during 2002–2005. In a study, 64% of these deceased were identified as potential donors. This represents 40.7 potential donors per million inhabitants. It can be concluded that in the other donor regions of Germany a comparable number of potential donors exists, yet not all possible donors are being detected and referred. The conversion rate (percentage of potential donors who become effective donors) in the years 2002–2005 was 47%. The main reason for the conversion rate being so low was the large number of relatives who declined an organ donation (73%). More than 90% of the relatives in the north‐east region did not know the deceased's will in the acute situation. From our point of view the high refusal rate can be decreased mainly by two measures: improvement of the family approach and integrating the topic of organ donation into schools’ curricula.

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ystinuria with the overall prevalance of 1 person per 7.000 population is an autosomal-recessive defect in reabsorptive transport of cystine and dibasic amino acids ornithine, arginine, and lysine from the luminal fluid of the renal proximal tubule. Two genes SLC3A1 (located on chromosome 2p16.3-p21) and SLC7A9 (located on chromosome 19q12-13.1) are responsible for cysteine reabsorbtion. Mutations of these genes lead to inability of renal tubules to reabsorb cystine and phenotypic manifestation of cystinuria. The relative insolubility of cystine at physiological urine pH lead to stone formation, infection, obstruction and ultimately chronic kidney disease. 1,2 The other dibasic amino acids including ornithine, arginine and lysine are soluble, so increase in their urinary excretion does not lead to stones. Cystine stones which occur most commonly within the first two decades of life are found in 6-8% of pediatric renal lithiasis cases while 1-2% of adult stone formers. 2 The median age of onset of stones was reported as 12 years. 3 The appropriate management of cystinuria is often challenging and requires close follow-up of the patient. Here, recurrent cystine stone former 47 years old man with no sign of urolithiasis until 35 years of his life was presented. Unusual Cause of Nephrolithiasis: Cystinuria A AB BS S T TR RA AC CT T Cystinuria is a rare hereditary disease in which excretion of detectable amount of cysteine, lysine, ornithine and arginine amino acids in the urine is present leading to cysteine nephrolithiasis. Over 100 mutations for SLC3A1 and SLC7A9 genes were identified for this disease. 47 years old male patient suffering from recurrent nephrolithiasis analysis of which revealed L-cysteine type stone for the last 12 years applied to our hospital with the complaint of flank pain. Obesity, hyperglycemia, hypertriglyceridemia, microscopic hematuria, macroalbuminuria, multiple stones in the urinary tract with the diameter of 1 cm and hypercystinuria were detected. Urology consultation for stone removal, alkalization and increasing the volume of urine, life style modifications in order to lose body fat, potassium citrate and tiopronine were adviced to the patient. If stones passed through urinary tract are not analysed, diagnosis of cystinuria will be missed out. With this case, an unlucky but common state for patients with cystinuria is discussed.