Introduction: The purpose of the study was to evaluate the prevalence and significance of incidental adrenal lesions identified in potential living renal donors.

Methods: The medical record of 1,235 consecutive potential living renal donors (566 men and 669 women; age range, 18-74 years; mean age, 40.6 years) from June 2003 to November 2010 were reviewed. After a thorough initial clinical evaluation including medical history, physical and psychiatric examinations, biochemical and serological blood tests and urine evaluation, all potential donors underwent preoperative assessment with contrast enhanced Multi-detector row computed tomography (MDCT) angiography. Fifty six patients with 59 adrenal lesions were found.

Results: There were 23 males and 33 females, aged between 21–67yr (mean age, 47.8 yr; median, 49yr). Forty two (75%) donor were related: siblings 19(34%), parents 17(30%) and spouses 6(11%). BMI ranged from 17.4–41 [median, 28.2; underweight, 1(1.8%); normal range, 14(25%); overweight 23(41.1%); obese 18(32.1%)]. Mass size (computed tomography measurement) ranged from 0.5–3.3 cm (average 1.2cm; median, 1.0cm). Masses were more frequent on the left than on the right side [46 (82%) vs. 7 (13%); P<0.001], whereas bilateral masses were 3 (5%). Laboratory blood analysis showed: cortisol 0.5-2.0 ug/dl (median 0.7 ug/dl); renin 0.1-2.8 ng/ml/hr (median 0.8 ng/ml/hr); aldosterone 1.6-14 ng/dl (median 5.8 ng/dl); metanephrine <0.3 nmol/l; normetanephrine 0.2-0.52 nmol/l (median 0.39 nmol/l).

Conclusions: None of the lesions had abnormal endocrine activity and adrenalectomy was not performed. Of the 56 patients, 13 patients donated their kidney, and the adrenal lesions were not considered to be contraindications to donation. Given these results, endocrine analysis of asymptomatic small incidental adrenal lesions may not be necessary.

« Back to 2013 American Transplant Congress