Outcomes of transplants from patients with small renal tumours, live unrelated donors and dialysis wait‐listed patients

We report the outcomes of renal transplant patients (n = 43) who received grafts from donors (n = 41) with small (<3 cm) renal tumours removed before transplantation covering the period from May 1996 to September 2007. Patient and graft survival were compared with the outcomes of conventional live unrelated transplants (LURTs) (n = 120) and to patient survival on the transplant waiting list for those who did not receive a kidney during this period (n = 153). Patient survival at 1, 3 and 5 years were 92%, 88% and 88% for recipients of tumourectomized kidneys (TKs), 99%, 97% and 97% for LURTs, and 98%, 92% and 74% for dialysis patients waiting for a deceased donor kidney (log rank score 10.4, P = 0.005). One patient experienced a local tumour recurrence at 9 years following transplantation. This patient declined intervention and is currently under active surveillance. Transplantation of tumourectomized kidneys from patients with small, localized, incidentally detected renal tumours results in similar outcomes to conventional LURTs and confers a significant survival advantage for patients who would otherwise be unable to receive a transplant.

[1]  David W. Johnson,et al.  Kidneys from patients with small renal tumours: a novel source of kidneys for transplantation , 2008, BJU international.

[2]  J. Kaouk,et al.  Complications of laparoscopic surgery for urological cancer: a single institution analysis. , 2007, The Journal of urology.

[3]  D. Lin,et al.  Trends in renal cancer surgery and patient provider characteristics associated with partial nephrectomy in the United States. , 2007, Urologic oncology.

[4]  R. Wolfe,et al.  Renal Transplantation in Elderly Patients Older Than 70 Years of Age: Results From the Scientific Registry of Transplant Recipients , 2007, Transplantation.

[5]  Stephanie Daignault,et al.  Rising incidence of small renal masses: a need to reassess treatment effect. , 2007, Journal of the National Cancer Institute.

[6]  J. Kaouk,et al.  Percutaneous radiofrequency ablation of tumor in transplanted kidney. , 2007, Urology.

[7]  C. Pfister,et al.  Comparaison de la néphrectomie partielle par voie laparoscopique et par voie ouverte : une expérience multicentrique française , 2007 .

[8]  H. Poppel,et al.  The indications for partial nephrectomy in the treatment of renal cell carcinoma , 2006, Nature Clinical Practice Urology.

[9]  David C. Miller,et al.  Partial nephrectomy for small renal masses: an emerging quality of care concern? , 2006, The Journal of urology.

[10]  John T. Wei,et al.  National utilization trends of partial nephrectomy for renal cell carcinoma: a case of underutilization? , 2006, Urology.

[11]  A. Hanlon,et al.  The natural history of observed enhancing renal masses: meta-analysis and review of the world literature. , 2006, The Journal of urology.

[12]  P. Daloze,et al.  Renal Cell Carcinoma in Kidney Allografts: A Case Series from a Single Center , 2005, American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons.

[13]  F. Kondylis,et al.  The natural history of incidentally detected small renal masses , 2004, Cancer.

[14]  Y. Chrétien,et al.  Renal cell carcinoma of the grafted kidney: how to improve screening and graft tracking , 2004, Transplantation.

[15]  D. Delakas,et al.  Nephron-sparing surgery for localized renal cell carcinoma with a normal contralateral kidney: a European three-center experience. , 2002, Urology.

[16]  W. Chow,et al.  Global increases in kidney cancer incidence, 1973–1992 , 2002, European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation.

[17]  D. Nicol,et al.  Issues in the diagnosis of renal cell carcinoma , 2000, BJU international.

[18]  D. Churchill,et al.  Comparison of mortality risk for dialysis patients and cadaveric first renal transplant recipients in Ontario, Canada. , 2000, Journal of the American Society of Nephrology : JASN.

[19]  D. Nicol,et al.  A comparison of the effects of dialysis and renal transplantation on the survival of older uremic patients. , 2000, Transplantation.

[20]  J L Warren,et al.  Rising incidence of renal cell cancer in the United States. , 1999, JAMA.

[21]  A. Novick,et al.  Nephron-sparing surgery in a renal allograft. , 1997, Urology.

[22]  I. Penn Primary kidney tumors before and after renal transplantation. , 1995, Transplantation.

[23]  K. Bensalah,et al.  [Comparison of open and laparoscopic partial nephrectomy: a French multicentre experience]. , 2007, Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie.

[24]  C. Hernández-Fernández,et al.  Subcapsular nephron-sparing surgical approach for small renal graft tumor: a case report. , 2007, Transplantation proceedings.

[25]  Cecka Jm The OPTN/UNOS renal transplant registry. , 2005 .

[26]  J. Cecka,et al.  The OPTN/UNOS renal transplant registry. , 2004, Clinical transplants.

[27]  A. Novick,et al.  Nephron-sparing surgery for renal cell carcinoma. , 1998, British journal of urology.