OBJECTIVES: To assess transplantation of high-risk kidneys with incidental renal masses (found occasionally during the routine evaluation of a living kidney donor) into recipients with limited life-expectancy on haemodialysis, as this offers a potential solution to the current organ deficit. PATIENTS AND METHODS: We detected five small (<2.3 cm), incidental, enhancing renal masses during donor evaluation. All patients had a standard metastatic evaluation. After laparoscopic donor nephrectomy a back-table partial nephrectomy was performed and frozen-section analysis was used to confirm both the diagnosis and negative surgical margins before transplantation. RESULTS: Renal cell carcinoma was found in three of the five masses (one each cystic, clear cell and papillary; Fuhrman grades II, II and III, respectively) and the other two patients had angiomyolipoma. There were no long-term complications in the transplanted kidneys. One patient developed delayed acute humoral rejection after transplantation and was treated appropriately. Both donor and recipient were followed with periodic imaging. At a median (range) last follow-up of 15 (1-41) months, four patients were alive and one had died from complications after a fall. The cancer-specific survival was 100%. There was no evidence of local recurrence in any patient at the last follow-up. CONCLUSION: Live donor kidneys with incidental small renal masses might be acceptable for transplantation in high-risk recipients after careful back-table partial nephrectomy.
OBJECTIVES: To assess transplantation of high-risk kidneys with incidental renal masses (found occasionally during the routine evaluation of a living kidney donor) into recipients with limited life-expectancy on haemodialysis, as this offers a potential solution to the current organ deficit. PATIENTS AND METHODS: We detected five small (<2.3 cm), incidental, enhancing renal masses during donor evaluation. All patients had a standard metastatic evaluation. After laparoscopic donor nephrectomy a back-table partial nephrectomy was performed and frozen-section analysis was used to confirm both the diagnosis and negative surgical margins before transplantation. RESULTS:Renal cell carcinoma was found in three of the five masses (one each cystic, clear cell and papillary; Fuhrman grades II, II and III, respectively) and the other two patients had angiomyolipoma. There were no long-term complications in the transplanted kidneys. One patient developed delayed acute humoral rejection after transplantation and was treated appropriately. Both donor and recipient were followed with periodic imaging. At a median (range) last follow-up of 15 (1-41) months, four patients were alive and one had died from complications after a fall. The cancer-specific survival was 100%. There was no evidence of local recurrence in any patient at the last follow-up. CONCLUSION: Live donor kidneys with incidental small renal masses might be acceptable for transplantation in high-risk recipients after careful back-table partial nephrectomy.
Authors: Marta Melgosa Hijosa; Angel Alonso Melgar; Ma José Martínez Urrutia; Carmen García Meseguer; Enrique Jaureguizar Monereo; Mercedes Navarro Torres Journal: Pediatr Nephrol Date: 2012-07-18 Impact factor: 3.714
Authors: Krista L Lentine; Bertram L Kasiske; Andrew S Levey; Patricia L Adams; Josefina Alberú; Mohamed A Bakr; Lorenzo Gallon; Catherine A Garvey; Sandeep Guleria; Philip Kam-Tao Li; Dorry L Segev; Sandra J Taler; Kazunari Tanabe; Linda Wright; Martin G Zeier; Michael Cheung; Amit X Garg Journal: Transplantation Date: 2017-08 Impact factor: 4.939
Authors: S Maleki Vareki; M J Harding; J Waithman; D Zanker; A N Shivji; M Rytelewski; D M Mazzuca; M A Yekta; W Chen; T D Schell; S M M Haeryfar Journal: Am J Transplant Date: 2011-10-25 Impact factor: 8.086
Authors: Elizabeth C Lorenz; Terri J Vrtiska; John C Lieske; John J Dillon; Mark D Stegall; Xujian Li; Eric J Bergstralh; Andrew D Rule Journal: Clin J Am Soc Nephrol Date: 2010-01-14 Impact factor: 8.237