Introduction: In order to expand the donor pool in kidney transplantation, it has been reported that there is no contraindication kidneys with simple cysts below 3cm transplanting them. On the other hand, there are also studies suggesting that simple cysts increase in size and number over time, disrupt the renal structure and cause an increase in creatinine values. In this study, we aimed to evaluate the long-term outcomes of transplanted kidney grafts with cysts.
Method: Since 1978, 3517 kidney transplants have been performed by our team for the first time in Turkey and the region. Among these kidney transplants performed by our team between February 2012 and August 2023, those whose grafts contained simple cysts were retrospectively analysed. Demographic characteristics, cyst size, perioperative complications, postoperative creatinine levels and cyst size during the follow-up period were recorded.
Results: Between February 2012 and August 2023, 65 kidney transplants were included in the study. The mean age of the recipients was 50.3 years (31-71) and 38 (58%) were women. All donors were related to their recipients. The mean cyst size was 14 mm. Of the grafts, 8 (12.3%) had cysts <5 mm, 17 (26.1%) had cysts between 5-10 mm, and 40 (61.5%) had cysts >10 mm. No intraoperative complications were observed in any of the donors or recipients. Urinary tract infection developed in 8 patients within 1 week postoperatively, but recovered completely with iv. antibiotic treatment. In the control ultrasonography performed at the 6th postoperative month, 43 of 65 patients showed a decrease in the size of the cyst in the graft kidney, while 15 patients had enlarged cysts. Except for 1 patient, the enlarged cysts did not require additional intervention except for follow-up. Only 1 patient's cyst was >5cm and excision was performed. Postoperative day 1, week 1, month 1 and year 1 values were 2.48 mg/dl, 1.42 mg/dl, 1.23 mg/dl and 1.42 mg/dl, respectively.
Conclusion: Kidney grafts with simple cysts do not constitute an obstacle for kidney transplantation provided that the transplantation is performed by experienced centers and they are followed up regularly.