Kidney transplant and adrenal glands?

Question

When a kidney is transplanted from a donor to a recepient does the surgery occur keeping the donor's adrenal gland intact over the kidney or is the kidney minus the adrenal gland over it transplanted to the recepient?

Answer 1

Hello, it is my understanding that the donor's adrenal gland is kept in place. Very rarely the adrenal is removed. However, there is a difference that depends on what kidney is transplanted. When the left kidney is transplanted, it requires ligation of the adrenal vein (drains into inferior vena cava). When the right kidney is transplanted, the adrenal vein is not ligated (drains into right renal vein). For this reason patients may develop adrenal insufficiency after a left kidney transplant if the contralateral adrenal does not hypertrophy (cases of low ACTH stimulation).