Kidneys From Donors With Incidental Renal Tumors

Musquera, Mireía; Pérez, Manuel; Peri, Lluís; Esforzado, Núria; Sebastià, M. C.; Paredes, David; Ribal, María J.; Oppenheimer, Federico; Campistol, Josep M.; Alcaraz, Antonio

doi:10.1097/tp.0b013e3182875e00

Cited by 24 publications

(2 citation statements)

References 12 publications

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“…Cases of back table excision of small renal cell carcinomas after donor nephrectomy, followed by use of the kidney for transplantation have been reported. 345 - 348 Based on review of cancer registry reports, published literature and disease transmission cases reported to the OPTN, a 2011 OPTN DTAC Malignancy Subcommittee concluded, from a disease-transmission perspective, that “… kidneys with small, solitary, well differentiated renal cell carcinoma may be usable for transplantation provided the lesion itself is completely resected." 341 While partial (rather than complete) nephrectomy is often the treatment choice for small renal cell carcinomas for the purpose of nephron-sparing with comparable cure rates in affected individuals, persons planning kidney donation intend to undergo complete nephrectomy.…”

Section: Rationalementioning

confidence: 99%

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

et al. 2017

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The 2017 Kidney Disease: Improving Global Outcomes (KDIGO) Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors is intended to assist medical professionals who evaluate living kidney donor candidates and provide care before, during and after donation. The guideline development process followed the Grades of Recommendation Assessment, Development, and Evaluation (GRADE) approach and guideline recommendations are based on systematic reviews of relevant studies that included critical appraisal of the quality of the evidence and the strength of recommendations. However, many recommendations, for which there was no evidence or no systematic search for evidence was undertaken by the Evidence Review Team, were issued as ungraded expert opinion recommendations. The guideline work group concluded that a comprehensive approach to risk assessment should replace decisions based on assessments of single risk factors in isolation. Original data analyses were undertaken to produce a “proof-in-concept” risk-prediction model for kidney failure to support a framework for quantitative risk assessment in the donor candidate evaluation and defensible shared decision making. This framework is grounded in the simultaneous consideration of each candidate's profile of demographic and health characteristics. The processes and framework for the donor candidate evaluation are presented, along with recommendations for optimal care before, during, and after donation. Limitations of the evidence are discussed, especially regarding the lack of definitive prospective studies and clinical outcome trials. Suggestions for future research, including the need for continued refinement of long-term risk prediction and novel approaches to estimating donation-attributable risks, are also provided.In citing this document, the following format should be used: Kidney Disease: Improving Global Outcomes (KDIGO) Living Kidney Donor Work Group. KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors. Transplantation. 2017;101(Suppl 8S):S1–S109.

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Section: Rationalementioning

confidence: 99%

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

et al. 2017

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“…Total nephrectomy and donation may be offered in exceptional cases where rescue therapy is indicated or donor and recipient are well informed and decide to accept the risk of recurrence. Some case series describe donors with incidental renal masses in living and deceased kidney donors, which were resected with clear margins on the back table and where no local recurrence or metastasis were observed in long-term follow-up [15–17]. …”

Section: Case Reportmentioning

confidence: 99%

Algorithm for Bosniak 2F Cyst in Kidney Donation

et al. 2017

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Patient: Female, 54Final Diagnosis: Multilocular cystic renal cell carcinoma with clear cellsSymptoms: NoneMedication: —Clinical Procedure: Hand-assisted retroperitoneal donor nephrectomySpecialty: TransplantologyObjective:Unusual setting of medical careBackground:The Bosniak system for radiological classification of renal cysts offers a tool for surgical decision-making in clinical practice. Although 95% of Bosniak 2F cysts remain benign, a consensus on the management of Bosniak 2F cysts in kidney donation has not been developed.Case Report:We present a donor with a Bosniak 2F cyst, who successfully donated her kidney after partial resection of the Bosniak 2F cyst. Postoperative pathology examination of the partially resected cystic wall revealed a multilocular cystic renal cell carcinoma. Postoperative pathology examination revealed a multilocular cystic renal cell carcinoma. Resection of the Bosniak 2F cyst provides 2 advantages: the recipient receives a new donor kidney and will be free of dialysis, and the donor will be free of surveillance.Conclusions:We present a practical guideline for kidney donors with Bosniak 2F cysts, balancing the risk of tumor transmission or recurrence with the benefit associated with organ transplantation, without compromising the risk of the donor and recipient. Further evaluation of this algorithm by longer follow-up and more studies is needed to prove its safety.

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Contraindications to Living Kidney Donation

Hilton

2022

Living Kidney Donation

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Kidneys From Donors With Incidental Renal Tumors

Abstract: Kidneys with small incidental tumors can be considered an option for kidney transplantation in selected patients.

Cited by 24 publications

References 12 publications

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

KDIGO Clinical Practice Guideline on the Evaluation and Care of Living Kidney Donors

Algorithm for Bosniak 2F Cyst in Kidney Donation

Contraindications to Living Kidney Donation

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