Transplantation of kidneys with tumors

Frascà, Giovanni M.; D’Errico, Antonietta; Malvi, Deborah; Porta, Camillo; Cosmai, Laura; Santoni, Matteo; Salviani, Chiara; Gallieni, Maurizio; Balestra, Emilio

doi:10.1007/s40620-015-0249-2

Cited by 9 publications

(8 citation statements)

References 45 publications

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“…However, this novel source remains arguable as the fear of tumour recurrence. Many pioneers have advocated the implementation of this novel source for kidney transplantation [19–22,25,41–44]. Cohn et al have campaigned a decade ago: ‘We encourage urologic oncologists to open discussions with transplant surgeons about considering transplantation of kidneys after ex vivo excision of small renal masses, from very selected donors (who prefer radical to partial nephrectomy) and into very selected (high‐risk) recipients’ [42].…”

Section: Discussionmentioning

confidence: 99%

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

Mou

et al. 2020

Transpl Int

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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.

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Section: Discussionmentioning

confidence: 99%

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

Mou

et al. 2020

Transpl Int

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“…The current literature supports using kidneys with incidental low-grade RCC where polar resection and free surgical margins can be assessed [27,28]. The kidneys with incidental neoplastic lesions found at the time of the donor evaluation were not used in our series, even though they have been reported as plausible candidates [29]. To preserve the kidney, surgeons should perform a specific kind of resection: a lumpectomy or wedge resection with a rim of preserved renal parenchyma to allow the gross and microscopic assessment of margins.…”

Section: Discussionmentioning

confidence: 99%

Pathological features and outcomes of incidental renal cell carcinoma in candidate solid organ donors

Ambrosi

Ricci

Malvi

et al. 2020

Kidney Res Clin Pract

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Background: We report the findings of a single Italian center in the evaluation of renal lesions in deceased donors from 2001 to 2017. In risk evaluation, we applied the current Italian guidelines, which include donors with small (< 4 cm, stage pT1a) renal carcinomas in the category of non-standard donors with a negligible risk of cancer transmission. Methods: From the revision of our registries, 2,406 donors were considered in the Emilia Romagna region of Italy; organs were accepted from 1,321 individuals for a total of 3,406 organs. Results: The evaluation of donor safety required frozen section analysis for 51 donors, in which a renal suspicious lesion was detected by ultrasound. Thirty-two primary renal tumors were finally diagnosed: 26 identified by frozen sections and 6 in discarded kidneys. The 32 tumors included 13 clear cell renal cell carcinomas (RCCs), 6 papillary RCCs, 6 angiomyolipomas, 5 oncocytomas, 1 chromophobe RCC, and 1 papillary adenoma. No cases of tumor transmission were recorded in follow-up of the recipients. Conclusion: Donors with small RCCs can be accepted to increase the donor pool. Collaboration in a multidisciplinary setting is fundamental to accurately evaluate donor candidate risk assessment and to improve standardized protocols for surgeons and pathologists.

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“…Отримання інформації й сама інформована згода в процесі прийняття рішень у багатьох напрямках клінічної медицини є доволі актуальною, особливо в трансплантології, онкології, естетичній хірургії [9,29,30]. При впровадженні страхової й приватної медицини в подальшому інформована згода буде набувати все більшого значення.…”

Section: таблиця 1 інформована згода в різних галузях медициниunclassified

Информированное Согласие В Клинической Практике

Markov¹,

Zhezher²

2021

ЕМ

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В обзорной статье обсуждается вопрос информационного согласия пациентов на проведение диагностики, лечения, оперативного вмешательства и анестезии в различных областях медицины. Отмечено, что поддержка информированного согласия в теории биоэтики чаще всего базируется на понятиях автономии и права автономного агента принимать решения. Освещены первичная учетная документация и информация, которой пациент должен бать обеспечен в связи с ожидаемым лечением.

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Transplantation of kidneys with tumors

Cited by 9 publications

References 45 publications

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

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

Pathological features and outcomes of incidental renal cell carcinoma in candidate solid organ donors

Информированное Согласие В Клинической Практике

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