Rob,
Can you refresh our memory. Which kidney did you donate? If was the left, they tie off the left adrenal vein which causes blood to backup in the gland and clot there. This then infarcts or kills off the gland. The longstanding belief is that the adrenal gland has more than one vein to drain it. Because of the laparoscopic procedure urologists have been able to document that this was not a correct assumption. Is estimated more like 90% of us have a lone adrenal vein on the left. They need to cut off this vein since drains into the renal vein on that side not directly into the inferior vena cava as does on the right.
Moving forward, transplant donor surgeons should have to document in the operative report whether or not the donor has a lone vein or not. If only one, this means for sure this donor should be followed for adrenal dysfunction. There are blood tests which can be done. If the adrenal hormone tests are abnormal once get to six months, this means that gland is lost. Keep in mind there is not test to determine of the other gland is OK. Swiss surgeons also think that once tie off the left gland, the increased blood pressure/flow to the contralateral gland stuns it and can cause issues with its health.
Regardless which kidney was taken, keep in mind the adrenal sits on top of the kidney so yes, it can be injured surgically as can any other organ or tissue near the kidney. This then would be an operator error. In years past, a radical nephrectomy was done in the setting of kidney cancer thinking that since the adrenal was so close that it too, might have cancer. The literature notes that depending on the size of the tumor this is not necessary. So they spare the adrenal if possible. Then--the urologist out of concern for long term health risks especially for cardiovascular disease have come to the point that they do renal sparing surgery. They take the tumor only if small and spare the kidney. Less renal mass means more risk long term. Time for transplant surgeons to stop the misinformation about our risks and include all this information as part of donor consent. Time for a standard consent and focus on aftercare.
Keep uas posted. Hope you feel better soon.
Donna