Simple Cysts in Donor Kidney Contribute to Reduced Allograft Function

Abstract

Background: Simple renal cysts may be an early marker of renal disease. We investigated whether simple cysts in donor kidney are associated with the decline of allograft function in living donor kidney transplantation. Methods: We retrospectively reviewed records of donors and recipients from 716 living donor kidney transplants performed between April 2007 and April 2015 in our hospital. Ninety-one donors with renal cysts and 64 recipients with cysts in donor kidney were noted. We compared these 64 cases to 128 no cyst-bearing controls matched for the donor gender, recipient gender, donor baseline serum creatinine (sCr), donor/recipient body surface area ratio, donor age, recipient age and the date of kidney transplantation in turn. Results: The presence of cysts was interrelated with age, gender and renal function independently in donors. Pathological findings of time-zero biopsy revealed that donor kidney harboring cysts existed more glomerular sclerosis compared with no cyst-bearing controls (p = 0.040). The estimating glomerular filtration rate levels of recipients were 80.82 ± 26.61 vs. 88.21 ± 23.12, 66.95 ± 17.42 vs. 72.15 ± 16.42 and 60.92 ± 22.17 vs. 68.72 ± 14.43 ml/min· 1.73 m² in cyst-bearing and no cyst-bearing group on day 7, month 6 and year 5, respectively, after surgery (p < 0.05). The mean sCr were 112.14 ± 48.32 vs. 98.75 ± 29.71 and 126.28 ± 42.32 vs. 115.05 ± 26.35 μmol/l on the 7th day and a half year after transplant, respectively (p < 0.05). The 2 groups did not significantly differ in terms of the other characteristics. Conclusion: Simple cysts in donor kidney can influence the early and long-term allograft function. In living donor transplantation, kidney presenting cysts should be considered carefully at the time of donor selection.

Long‐term renal function in living kidney donors with simple renal cysts: A retrospective cohort study

“…Our finding that donors with retained renal cysts had slightly lower eGFR at baseline than donors without cysts (median 94 vs 98 mL/min/1.73 m 2 , P < .01) is consistent with a recent study of 716 living donor transplants performed in China, which found that donors with renal cysts (N = 91) had lower predonation eGFR (100 vs 106 mL/min/1.73 m 2 ) 40 . While donors with retained cysts had a lower average eGFR than those without cysts at baseline (difference = −5.6, P < .001) and throughout the follow‐up period, this association was confounded by donor age at donation: When adjusting for age alone, the association between retained cysts and eGFR was not significant ( P = .4).…”

Retrospective analysis of simple and stage II renal cysts: Pediatric nephrology point of view

“…In adult patients a correlation has been shown between simple cysts and hypertension and renal dysfunction . Grafts with simple cysts have been shown to have increased allograft dysfunction . Until now, no reports have linked simple cysts with renal dysfunction in children.…”

“…[17][18][19] Grafts with simple cysts have been shown to have increased allograft dysfunction. 20 Until now, no reports have linked simple cysts with renal dysfunction in children. In the present study, however, 22% of the renal cyst patients had eGFR <90 mL/min/1.73 m 2 , and two patients had hypertension that was unrelated to any other cause.…”

Non‐standard criteria donors in pediatric kidney transplantation

“…The presence of simple renal cysts in donor kidney is also associated with decline in allograft function, as these cysts represent an early marker of renal disease. Data show that the presence of simple cysts in donor kidney influences early and long‐term allograft function, but not 5‐year allograft survival . There is a lack of pediatric data, and also of analysis, between LDs with simple cyst vs SCD.…”

“…Data show that the presence of simple cysts in donor kidney influences early and long-term allograft function, but not 5-year allograft survival. 63 There is a lack of pediatric data, and also of analysis, between LDs with simple cyst vs SCD. or shunt operation has been performed.…”