Living‐donor renal transplantation of grafts with incidental renal masses after ex‐vivo partial nephrectomy

Abstract

metastatic evaluation. After laparoscopic donor nephrectomy a back-table partial nephrectomy was performed and frozensection analysis was used to confirm both the diagnosis and negative surgical margins before transplantation. RESULTSRenal 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.

Utility of MRI in the Characterization of Indeterminate Small Renal Lesions Previously Seen on Screening CT Scans of Potential Renal Donor Patients

“…Excision of such tumors, including angiomyolipomas, does not seem to affect graft or recipient survival [24,25]. The exact size thresholds delineating when to excise angiomyolipomas are unclear, although angiomyolipomas larger than 5 mm may warrant surgical excision [26]. At our institution, angiomyolipomas, regardless of their size, direct the transplant surgeon toward using the affected kidney for donation.…”

Expanding living kidney donor criteria with ex-vivo surgery for renal anomalies

“…9 However, attitudes towards this have changed in individuals with no prior stone history and those with a negative metabolic workup. Our results corroborate the findings of several studies that have demonstrated the safety and ease of performing ex-vivo ureteroscopy prior to renal implantation.…”

Kidneys From Donors With Incidental Renal Tumors

“…In the literature, few series have been described using grafts with small renal tumor after bench surgery excision. Sener et al (14) published their series of five kidney transplant recipients with kidneys with incidentally diagnosed renal mass before implantation in live related donors. Three of them were small and low-grade RCC.…”