Renal diseases not transmissible via HCST

Includes:

Congenital malformation

Nephrectomy after injury or dysfunctional kidney (e.g. hydronephrosis from childhood)

Organ donation

Nephrolithiasis (kidney stones)

Polycystic kidney disease

Individual at risk

Donor

Guidance at RECRUITMENT for adult volunteer donor and maternal donor (cord blood donation)

UNACCEPTABLE if progressive disease and / or global renal function is impaired.

Guidance at CT/WORK-UP

PERMANENT DEFERRAL if progressive disease and / or global renal function substantially impaired.

Otherwise, according to clinical reasoning by the assessing physician, the donor could be eligible, temporarily unavailable or permanently deferred.

Evaluate carefully for absence of inflammatory (autoimmune or infectious) nephropathy. If there is a suspicion of an inflammatory nephropathy, but renal biopsy is not indicated, inform the requesting transplant centre and proceed if requested (bone marrow collection only).

Nephrolithiasis: Assess the type of kidney stones in the available medical history. Because of transient history of uric acid stones should be for bone marrow collection only.

Justification for guidance

Donors with progressive disease or global renal impairment may be at increased risk of adverse events associated with donation by either route.

Renal diseases transmissible via HCST

Condition

Chronic infectious or autoimmune diseases, including (for example):

Tuberculosis

Chronic pyelonephritis

IgA nephropathy

Chronic glomerulonephritis

Individual at risk

Donor / recipient

Guidance at RECRUITMENT for adult volunteer donor and maternal donor (cord blood donation)

UNACCEPTABLE

Guidance at CT/WORK-UP

UNACCEPTABLE, PERMANENT DEFERRAL

Justification for guidance

Donors with chronic infectious or autoimmune disease may experience exacerbations of their disease as a result of donation. In addition, there is a risk of transmission of infectious agents or autoreactive lymphocytes to the recipient.

References

Nasilowska-Adamska B, Perkowska-Ptasinska A, Tomaszewska A, Serwacka A, Marianska B. Acute glomerulonephritis in a donor as a side effect of allogeneic peripheral blood stem cell mobilization with granulocyte colony-stimulating factor. Int J Hematol 2010;92(5):765-8.