TCC in Transplant Ureter—When and When Not to Preserve the Transplant Kidney

Abstract

We present four cases of transitional cell carcinoma of the transplant ureter (TCCtu). In three cases, localized tumor resection and a variety of reconstructive techniques were possible. Transplant nephrectomy with cystectomy was performed as a secondary treatment in one locally excised case. Transplant nephroureterectomy was performed as primary treatment in one case. The role of oncogenic viruses and genetic fingerprinting to determine the origin of TCCtu are described. Our cases and a systematic literature review illustrate the surgical, nephrological, and oncological challenges of this uncommon but important condition.

Urothelial carcinoma arising from the transplanted kidney: A single‐center experience and literature review

“…10,28,30,31 No follow-up information was also available for further 7/36 3,34,35 and for the remnant cases, there is often a limited follow-up. Subsequent successful transplantation has been reported in selected cases after an extended disease-free interval 33 ; whilst we are unable to comment based on the short duration of follow-up, patients could potentially be considered for further transplantation after an appropriate disease-free period, generally 1 year. 15 Upper tract UC in our cases and the majority of previously reported cases would thus appear to have developed subsequent to renal transplantation.…”

Donor-Derived Urothelial Carcinoma in Renal Transplant Recipients

“…While donor-derived UCs reported in the past often present with extensive involvement and distant, disease-free state of up to 10 years has been achieved from timely surgical intervention alone [ 13 ]. This case reported by Olsburgh et al also received a second kidney transplantation and maintained good renal functions [ 13 ]. Research on the optimal timing of redoing allotransplantation after the complete remission of donor-related malignancy is lacking.…”

Urologic malignancies in kidney transplantation

“…UC is rarely found in the transplanted kidney, and the allograft can often be preserved during treatment. However, there are case reports of allograft malignancies requiring either local resection and reconstruction or nephroureterectomy and lymphadnectomy . One of the largest series detailing treatment of bladder cancer after kidney transplantation followed standard therapy despite immunosuppression: intravesical BCG [live attenuated bacteria and works through immunomodulation and therefore has 2 implications in the transplant population: (i) may be less effective in someone receiving immunosuppression and (ii) immunosuppressed patients may be at higher risk for BCG complication including sepsis] for noninvasive tumors and radical cystoprostatectomy with lymphadenectomy and urinary diversion for invasive tumors .…”