Successful Transplantation of Kidneys from Living Donors with Renal Artery Aneurysms: Exploring New Avenues

Renal artery aneurysms (RAAs) are rare, mostly asymptomatic, and typically discovered incidentally. The potential to utilize kidneys with incidentally detected RAAs for transplantation remains largely unexplored despite the pressing need to expand the donor pool. We report two successful renal transplantations from altruistic living donors with incidentally detected RAAs, both managed with ex vivo surgical reconstruction during bench surgery. Preoperative detailed imaging and renal function studies were performed, and detailed informed consent was obtained from both the prospective donor and recipient prior to transplantation. The RAA was excised in total and reconstructed with the remnant allograft renal artery prior to transplantation. Both recipients had immediate graft function and uneventful postoperative recovery. Renal function remained normal in both donors and recipients over short-term follow-up (6 months). Transplantation using kidneys from altruistic live donors with RAAs is feasible and safe with meticulous surgical planning and ex vivo reconstruction. This technique offers a promising avenue for expanding the donor organ pool where deceased donors are scarce.