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2017 ; 92
(5
): 361-364
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Experiences of renal transplants from donors with renal cell carcinoma after ex
vivo partial nephrectomy
#MMPMID28480182
Lim SY
; Kim MG
; Park KT
; Jung CW
Ann Surg Treat Res
2017[May]; 92
(5
): 361-364
PMID28480182
show ga
PURPOSE: Routine evaluation of kidney donors occasionally reveals an incidental
renal mass with an otherwise satisfactory kidney function. The use of such a
kidney with an enhancing mass for transplantation is a matter of debate owing to
a possible risk of transmission of donor malignancies. We report our experience
of kidney transplants from donors with renal cell carcinoma, after ex vivo
resection of the renal mass. METHODS: Two women aged 44 and 56 years were
diagnosed with enhancing renal masses measuring 0.9 cm and 0.7 cm, respectively,
during donor evaluation for kidney transplantation. Both patients and their
families were informed of a potential risk of recurrent renal cell carcinoma
following transplantation. RESULTS: Renal function test results of both donors
satisfied the living donor selection criteria. Laparoscopic live donor
nephrectomy was performed with ex vivo resection of renal masses on the bench
table. Immediate pathological analysis revealed a renal cell carcinoma with a
margin of normal renal parenchyma before transplantation. Regimens based on
mammalian target of rapamycin inhibitors, which are known for their antitumoral
properties, were used for immunosuppression in both recipients. None of the
recipients showed recurrence or metastasis during the follow-up period, which was
longer than 3 years after transplantation. CONCLUSION: In light of the ongoing
shortage of kidney donors, kidneys with small renal cell carcinoma could be
considered for transplantation after appropriate removal of the lesion, with a
very low risk of recurrent disease.