Renal Artery Calcification and Stenosis in Potential Live Kidney Donors: Results of a UK-Wide National Survey of Transplant Surgeons.

Abstract

Renal artery calcification (RAC) is highly associated with calcification in other vascular beds, independent of traditional risk factors. There is no evidence-based consensus on the suitability for live donor nephrectomy (LDN) in donors with non-flow limiting RAC or renal artery stenosis (RAS). This national survey aimed to explore opinions of all renal transplant surgeons in the UK. Methods: An online survey was distributed to 101 renal transplant surgeons from 23 institutions in the UK. Opinions were sought on donor suitability with unilateral or bilateral RAC or RAS, in the context of anti-hypertensive treatment (0, 1, 2 or 3+ agents) and presence or absence of other vascular disease. Results: The response rate was 66.3%.Table: No Caption available.Conclusions: This national survey has demonstrated that there is a tendency for UK transplant surgeons to consider a donor with RAC potentially suitable for LDN, however opinion varies depending on the number of anti-hypertensive agents, comorbidities and whether both renal arteries are affected. Most respondents consider bilateral RAS a contraindication to LDN, irrespective of comorbidities. Further studies are required to investigate.