Faculty Collaboration Database

Living Kidney Donors With Adrenal Incidentalomas: Are They Appropriate Donors? Urology 2016 Jan;87:100-5

Date

10/27/2015

Pubmed ID

26499786

DOI

10.1016/j.urology.2015.10.004

Scopus ID

2-s2.0-84959285109 (requires institutional sign-in at Scopus site)

Abstract

OBJECTIVE: To determine the incidence of adrenal incidentalomas (AIs) in a single-center series of living renal donors, to describe an evaluation algorithm for AIs in this patient population, and to compare the complication rates of hand-assisted laparoscopic donor nephrectomy (HALDN) with those of combined HALDN and adrenalectomy.

METHODS: We performed a single-center, retrospective study of consecutive living kidney donors who underwent laparoscopic nephrectomy for transplantation, with or without simultaneous ipsilateral adrenalectomy, between January 2008 and September 2014.

RESULTS: During the study period, AIs were detected in 18 of 1033 potential living renal donors who underwent computerized tomographic angiography. Application of additional donor selection criteria and of an adrenal mass assessment algorithm resulted in 849 HALDN, of which 13 were combined with simultaneous adrenalectomy. The hospital length of stay (2.4 vs 2.6 days), perioperative (0.025 vs 0.077), early (0.073 vs 0.077), and late (0.014 vs 0.077) postoperative complication rates, and conversion to open donor nephrectomy (0.008 vs 0.00) were not significantly different. Mean operative time was significantly longer in the adrenalectomy group. None of the adrenal masses were malignant.

CONCLUSION: Here, we presented our algorithm to manage the living kidney donors with AIs. Although donor population with AIs was relatively small in number, simultaneous adrenalectomy and ipsilateral nephrectomy seemed to be technically safe and conferred no identifiable increased risk of malignancy for the kidney transplant donor, when the incidentaloma is nonfunctional and less than or equal to 4 cm as assessed by preoperative imaging.

Author List

Arpali E, Aslan A, Scalea J, Karatas C, Akinci S, Altinel M, Kocak B

Author

Emre Arpali MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adrenal Gland Neoplasms
Adrenalectomy
Female
Humans
Kidney Transplantation
Laparoscopy
Living Donors
Male
Middle Aged
Nephrectomy
Retrospective Studies
Tissue and Organ Harvesting