Abstract: SA-PO1072
Successful Kidney Donation After Gastric Bypass Surgery Using Individualized Stone Risk Assessment
Session Information
- Transplantation: Clinical - II
November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Krishnamoorthy, Sambhavi, University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Zisman, Anna L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
Background
The effects of increased prevalence of morbid obesity in the general population is reflected in the population presenting for living kidney donation as well. Bariatric surgery is the most successful and longest-lasting treatment for morbid obesity. Some centers may exclude donors who have undergone Roux en Y gastric bypass due to the risk of hyperoxaluria and risk of stone events post donor nephrectomy. We describe four living donor candidates who underwent evaluation at our kidney stone prevention program that allowed an individualized risk assessment to assess their candidacy keeping donor safety as a priority.
Methods
Retrospective review of electronic medical records was used to identify four living kidney donor (LKD) candidates with history of Roux en Y gastric bypass between 2012 and 2022. Patients submitted paired 24 hour blood and urine samples for metabolic evaluation. We compared the characteristics of the LKDs who went on to donate and the ones who were declined.
Results
Table 1a and 1b summarize the demographics and urinary metabolic parameters. Patient 1 went on to donate kidney as she did not have any hyperoxaluria. Patient 2 had hyperoxaluria on her initial testing,which normalized on repeat testing after counseling (Table 1c). She went on to successfully donate. Both patients 3 and 4 were declined as candidates for living kidney donation due to significant hyperoxaluria. The patients who were approved for donation were 10 years and 14 years out from gastric bypass surgery versus the ones who were declined who were 1 and 2.5 years out respectively.
Conclusion
Successful living kidney donation after bariatric surgery is possible with careful individualized evaluation of metabolic stone risk paramatersat an experienced stone center prior to approving their candidacy.