Treatment of donors ’ asymptomatic small kidney stones and post-transplant outcomes: a meta-analysis

AbstractKidney donors with asymptomatic small kidney stones were increasingly accepted in kidney transplantation (KT) due to organ shortage and advances in endoscopic urology. However, recipients ’ clinical outcomes using these donors remained unclear. We conducted a meta-analysis to summarize transplant outcomes using these donors with asymptomatic small kidney stones. Finally, 15 retrospective studies were included. The prevalence of asymptomatic small kidney stones was 5.3% (95%CI 3.5– 7.8%). After transplantation, low incidence of urinary fistula (0%, 95%CI 0–1.0%), obstruction (0%, 95%CI 0–1.1%), relapse of kidney graft stone (0.3%, 95%CI 0–2.5%), and delayed graft function (0.6%, 95%CI 0–3.5%) was reported. Pooled serum creatinine was 1.3 (95%CI 1.2–1.5) mg/dl and 1.4 (95%CI 1.2–1.6) mg/dl at post-transplant 1 month and 1 year, respectively. Notably, we observed numerically higher relapse rate after conservative management (1.8% [0–9.2%] vs 0% [0–1.8%]) but numerically higher DGF rate after surgical removal of asymptomatic stones (1.8% [0–7.0%] vs 0% [ 0–1.9%]). Overall, short-term transplant outcomes using kidneys with asymptomatic small stones were acceptable. However, long-term transplant outcomes remained unexplored. Well-designed prospective studies are also needed to compare the efficacy of conservative management with surgical removal of “donors’ gifted” asymptomatic kidney stones.
Source: Urolithiasis - Category: Urology & Nephrology Source Type: research