Donor – possible left adrenal gland problem?

[kristina]

Hallo,
My husband (donor) and I (recipient in a "Pooled and Paired" transplant) are concerned about the removal of my husband’s left kidney
and the effect this may have on possible adrenal insufficiency.
The left adrenal gland vein drains first into the left kidney and then into the inferior vana cava.
When the left kidney is removed, this vein is severed which can leave the adrenal gland,
which sits on top of the kidney, functionally impaired.
(Because the right kidney is set-up differently this problem does not occur there).
Our questions are: Does the surgeon reconnect the severed vein, thereby leaving the left adrenal gland working normally?
Or, is the left adrenal gland permanently out of action and would this cause adrenal insufficiency?
We have thought that if the right kidney is deemed to be only slightly more efficient than the left kidney,
would it not be better to have the right kidney (the better one) taken out in order to leave the left kidney unaffected
with regard to the severing of the adrenal glands vein?
I think I am right in saying, that a permanent impairment of the left adrenal gland will lead to a hypertrophy of the contralateral gland
(roughly speaking an enlargement of the cells in the right kidney) ?
Thank you from Kristina.

[Angiepkd]

This is a very interesting question.  I had both kidneys removed , and one of my kidney docs asked if they left my adrenal glands.  I had no idea, and still don't.  I haven't seen the surgeon since the operation.  I received a kidney from my husband in March, and I didn't even think to ask if they leave the adrenal gland with him and if it would still function.  Please let me know what you find out, as I am curious, too.  Hope everything works out for you!

[cassandra]

Hi Kristina, and Angie, they took both my kidneys out, had my dad's kidney for 13 years, after sepsis, and stuff they took that one out too, and as I'm still alive, I think they don't remove the adrenal gland.
Just
               

[kristina]

Thank you Angiepkd and Cassandra for your kind thoughts.
... With regard to my point about the left kidney I wonder what a surgeon would say if he was asked
which of his kidneys would he donate if both of his kidneys were of equal function and health?
Thanks again from Kristina.

[cassandra]

It also depends on how 'easy' it is to remove the kidney. As in where it is exactly

       

[kristina]

Thank you again, Cassandra.
... What makes the left kidney donation more complicated, is the fact that, I hope I am right here,
the left donor's kidney is easier to re-connect in the recipient because it will have a longer vein, artery and ureter
to "hook up" in the recipient (so this makes it easier for the surgeon).
If this is true, do the surgeons therefore favour taking the left kidney of a life-donor ?
So this point, if true, very much brings into focus my original post concerning the tying of the left adrenal vein
which might cause problems as I have outlined above.
Thanks again from Kristina.

[okarol]

Good questions for your transplant team.
Or post on www.livingdonorsonline.org and perhaps other donors will have answers.

[kristina]

Thank you okarol for the links.
I have tried to "connect" with the link of the living donors,
but unfortunately I could not register, as much as I try...
Perhaps my husband might be luckier when he gives it a try later on...?
... and... I do hope a donor visits IHD to perhaps answer the question...?
Thanks again from Kristina.

[kristina]

P.S.
I am wondering whether I have problems to register
at the link of "living donors" because of my UK-email-adress??
(I have tried again and it continues to be impossible to register there ...

[kristina]

It seems certain now that it is our UK-email adress that prevends us from registering at the "living donors online" ...

[noahvale]

*

[okarol]

It seems certain now that it is our UK-email adress that prevends us from registering at the "living donors online" ...

Oh no! That's crazy as we have members from all over the world.
Do you use facebook? There's a group on there too, an extension of the website https://www.facebook.com/groups/livingorgandonors/
Hopefully that will work.

[kristina]

Thank you very much for your precise replies, noahvale and okarol.

Thank you okarol for letting us know the details of facebook.... at the moment we have not signed-up to facebook yet,
so this might be something we attend to in the future. Thanks again.

I take your point noahvale about the fact that any concerning issues would by now be widely mentioned
this would be logical, as John Whelchel, MD - Renal Transplant Surgeon says.
... I did not know the left kidney was easier to take out, which along with the other point of the ease of transplanting the left kidney
seems to put the left kidney as the favourite kidney to take out if it is deemed acceptable,
given that the other donor-tests point to the left kidney being the best option.
... My first thought at this moment is that for the donor it is a bit of a trade-off.
I mean by this that the left kidney seems the most desirable option and any subsequent minor problems resulting
(e.g. complication arising from the adrenal-gland) might be resolved in time.
Thanks again from Kristina.