Long‐term outcome of kidney transplant by using restored kidney grafts after tumour ex vivo excision – a prospective study

Abstract

The aim of this study is to report long-term outcomes of kidney transplantation by using the kidney graft after a small tumour ex vivo excision. A structured programme was established to use the restored kidney graft from urological referral after radical nephrectomy. The criteria were defined as tumour size ≤3 cm, margin clear on frozen section and recipients aged ≥60 years or those on the urgent list for transplantation as a result of imminent lack of dialysis access. The recipients were followed up regularly for surveillance of tumour recurrence. Between February 2007 and February 2018, 28 recipients had kidney transplantation by using the restored kidney grafts. The tumour size was 2.6 AE 0.7 cm. The follow-up was median 7 years without evidence of tumour recurrence. The patient and graft survival was satisfactory. Kidney transplantation by using restored kidneys after a small tumour excision is a novel source for selected recipients. The long-term patient and graft survival is satisfactory. Although there is a risk of tumour recurrence, it is rare event. Together with literature review, we would support use of kidney graft after a small tumour excision for selected recipients.

Optimizing the kidney donor pool: transplanting donor kidneys after partial nephrectomy of masses or cysts

“…Donor and recipients were followed for up to 135 months post-transplant without RCC recurrence. He et al ( 31 ) also report on their experience with 28 recipients that received a PN kidney graft transplant from living unrelated donors, showing no recurrence of malignancy at a median of 7.5 years of follow up. Regarding living donors with renal cysts, Grotemeyer et al ( 32 ) published a retrospective review of 268 living donor kidney transplants where 25 kidneys were found to have cysts.…”

Renal Cell Carcinoma in End-Stage Kidney Disease and the Role of Transplantation

“…He et al’s prospective study followed 28 KTRs whose donors received a radical nephrectomy to remove small tumors (≤3 cm) prior to transplant. Only 7% of KTRs experienced allograft rejection and a median of 7.5 years of follow-up revealed no tumor reoccurrence [ 62 ]. The study supports the notion that the risk of transmitting RCC to the recipient is minimal given pre-transplant resection.…”

Renal Cell Carcinoma and Kidney Transplantation: A Narrative Review

“…The latter has been pioneered by Australian transplant centers, and a recent report summarize that among 107 such transplantations, only 2 recurrences (1.87%) were seen after a median of 7 y of follow-up, making a strong argument for the low oncological risk. 69 However, most patients with a small RCC require only partial nephrectomy, ruling out donation. 70 Details of surgical technique and monitoring are reviewed elsewhere.…”