Transplantation of Restored Kidneys From Unrelated Donors After Resection of Renal Cell Carcinoma: Results From 10 Patients

Ogawa, Yoshihide; Kojima, Kazushi; Mannami, R.; Mannami, Makoto; Kitajima, Kumiko; Nishi, Mitsuo; Ito, Seiichi; Mitsuhata, Naoki; Afuso, Hisaaki

doi:10.1016/j.transproceed.2015.06.030

Cited by 11 publications

(8 citation statements)

References 83 publications

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“…Sundarajan et al documented an improved quality of life in 20 kidney recipients who received organs following excision of small renal cancers with no evidence of transmission. An overview of the use of donors with small renal cancers is provided by Lugo‐Baruqui et al Separate reports have documented good outcomes when using restored kidneys from individuals who have undergone nephrectomy for treatment of small RCC …”

Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma suspected at time of organ donation 2008‐2016: A report of the OPTN ad hoc Disease Transmission Advisory Committee Registry

Pavlakis

Michaels

Tlusty³

et al. 2019

Clinical Transplantation

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All 179 reports to the OPTN of potential renal cell carcinoma (RCC) transmission from 1/1/2008 through 12/31/2016 were reviewed. Cases were divided into those with donor tumor known or suspected at time of transplant (N = 147 donors), and those in which tumor was initially found after transplant (N = 32). We sought to understand the risk of transplanting either the affected kidney, the contralateral kidney or non‐renal organs from donors with a suspected/confirmed unilateral RCC. In the case of RCC found prior to transplant, transplantation of 21 kidneys following excision of tumor, 47 contralateral kidneys and 198 non‐renal organs was performed. No cases of RCC transmission were documented in this population. An additional six cases of live donor kidney transplantation involving resection of RCC were reported, also without transmission. Six of 9 other recipients in whom the diagnosis of RCC became available after implantation underwent allograft nephrectomy and 3 received tumor resection. No recurrent RCC was documented. Given the low rate of transmission and available treatment options, consideration should be given to judicious use of organs from donors with small solitary RCC.

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Section: Discussionmentioning

confidence: 99%

Renal cell carcinoma suspected at time of organ donation 2008‐2016: A report of the OPTN ad hoc Disease Transmission Advisory Committee Registry

Pavlakis

Michaels

Tlusty³

et al. 2019

Clinical Transplantation

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“…Most importantly, some transplant centres have implemented a structured programme with the intention to expand using the restored kidney grafts after radical nephrectomy for treating kidney tumour from urological referral [20‐23]. A pioneer group was Nicol et al, who have performed 56 cases of transplant by using restored kidney grafts since 1996.…”

Section: Discussionmentioning

confidence: 99%

“…In 1996, Dr. Nicol et al from Queensland (Australia) established a programme with the intention to use the kidney graft after ex vivo excision of a small tumour for transplant to selected elderly recipients, in the context of treating urology patients after radical nephrectomy [20]. Subsequently, there are a few more transplant centres that have implemented this programme including our unit (Western Australia) [21–23]. The aim of this study is to review the long‐term graft and patient outcomes of kidney transplant in our cohort by using a restored kidney after a small tumour ex vivo excision.…”

Section: Introductionmentioning

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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“…Ex-vivo partial nephrectomy for incidentally discovered renal masses with subsequent renal implantation has been described previously, with several reports demonstrating its applicability to small renal cell carcinomas. 11,[15][16][17] In a study of 14 patients who underwent renal implantation after ex-vivo partial nephrectomy for small renal masses (median size 2 cm), there was no evidence of recurrence after a mean followup of 69 months. 16 Other renal masses, such as cysts, can be managed quite easily with deroofing and argon beam ablation of the inner cyst lining.…”

Section: Discussionmentioning

confidence: 99%

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

McGregor

Rampersad

Patel

2016

CUAJ

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Introduction: Renal transplantation remains the gold standard treatment for end-stage renal disease, with living donor kidneys providing the best outcomes in terms of allograft survival. As the number of patients on the waitlist continues to grow, solutions to expand the donor pool are ongoing. A paradigm shift in the eligibility of donors with renal anomalies has been looked at as a potential source to expand the living donor pool. We sought to determine how many patients presented with anatomic renal anomalies at our transplant centre and describe the ex-vivo surgical techniques used to render these kidneys suitable for transplantation. Methods: A retrospective review was performed of all patients referred for surgical suitability to undergo laparoscopic donor nephrectomy between January 2011 and January 2015. Patient charts were analyzed for demographic information, perioperative variables, urological histories, and postoperative outcomes. Results: 96 referrals were identified, of which 81 patients underwent laparoscopic donor nephrectomy. Of these patients, 11 (13.6%) were identified as having a renal anomaly that could potentially exclude them from the donation process. These anomalies included five patients with unilateral nephrolithiasis, four patients with large renal cysts (>4 cm diameter), one patient with an angiomyolipoma (AML) and one patient with a calyceal diverticulum filled with stones. A description of the ex-vivo surgical techniques used to correct these renal anomalies is provided. Conclusions:We have shown here that ex-vivo surgical techniques can safely and effectively help correct some of these renal anomalies to render these kidneys transplantable, helping to expand the living donor pool.

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Transplantation of Restored Kidneys From Unrelated Donors After Resection of Renal Cell Carcinoma: Results From 10 Patients

Cited by 11 publications

References 83 publications

Renal cell carcinoma suspected at time of organ donation 2008‐2016: A report of the OPTN ad hoc Disease Transmission Advisory Committee Registry

Renal cell carcinoma suspected at time of organ donation 2008‐2016: A report of the OPTN ad hoc Disease Transmission Advisory Committee Registry

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

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

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