*Purpose: Living donor kidney transplant is the primary modality of renal transplants in many countries. However, donors frequently present with some challenging conditions like some urological issues. Due to organ shortage, a balanced decision must be made. There are no guidelines or generally accepted consensus toward these conditions. A survey about acceptance of living kidney donors with challenging conditions was conducted.

*Methods: a cross-sectional survey of the nephrologists and transplant surgeons about Acceptance of Marginal Live Kidney Donors.

It was sent to participants in different countries and through AST, ASTS, and ERA-EDTA. In-training fellows were excluded.

*Results: 3 questions related to challenging urological issues. 1- donors with stable 5cm simple renal cyst, majority of respondents would allow this donor to donate (n=112, 92%) after counselling. ( n=106, 87% ) would choose the kidney with the cyst.2- Incidentally found small renal stones, (n=91, 75% ) would allow donation of the kidney with the stone. Only 8% would decline this donor.3- old history of a single episode of renal colic 5 years ago, (n= 100, 82.6%) would allow the donation of the colic-side kidney after counselling. 10% would accept donation only in absence of substitutes.In general, transplant surgeons were more liberal in accepting donors with urological issues ( P=NS).

*Conclusions: Incidentally found kidney stone, old history of renal colic and solitary simple renal cyst are not viewed as solo contraindications for kidney donation by the study population.

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