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1
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Crocerossa F, Autorino R, Derweesh I, Carbonara U, Cantiello F, Damiano R, Rubio-Briones J, Roupret M, Breda A, Volpe A, Mir MC. Management of renal cell carcinoma in transplant kidney: a systematic review and meta-analysis. Minerva Urol Nephrol 2023; 75:1-16. [PMID: 36094386 DOI: 10.23736/s2724-6051.22.04881-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION After transplantation, approximately 10% of renal cell carcinomas are detected in graft kidneys. These tumors (gRCC) present surgeons with the difficulty of finding a treatment that guarantees both oncological clearance and maintenance of function. We conducted a systematic review and an individual patient data meta-analysis on the oncology, safety and functional outcomes of the available treatments for gRCC. EVIDENCE ACQUISITION A systematic search was performed across MEDLINE, EMBASE, and Web of Science including any study reporting perioperative, functional and survival outcomes for patients undergoing graft nephrectomy (GN), partial nephrectomy (PN) or thermal ablation (TA) for gRCC. Quade's ANCOVA, Spearman Rho and Pearson χ2, Kaplan-Meier, Log-rank and Standard Cox regression and other tests were used to compare treatments. Studies' quality was evaluated using a modified version of Newcastle Ottawa Scale. EVIDENCE SYNTHESIS A number of 29 studies (357 patients) were included. No differences between TA and PN were found in terms of safety, functional and oncological outcomes for T1a gRCCs. When applied to pT1b gRCC, PN showed no difference in complications, progression or cancer-specific deaths compared to smaller lesions; PN validity for pT2 gRCCs should be considered unverified due to lack of sufficient evidence. The efficacy and safety of PN or TA for multiple gRCC remain controversial. In case of non-functioning, large (T≥2), complicated or metastatic gRCCs, GN appears to be the most reasonable choice. Quality of evidence ranged from very low to moderate. Studies with large cohorts and longer follow-up are still needed to clarify oncological and functional differences. CONCLUSIONS PN and TA might be offered as a nephron-sparing treatment in patients with T1a gRCC. There is no significant difference between these options and GN in terms of oncological outcomes and complications. PN and TA offer similar functional outcomes and graft preservation. PN for T1b gRCC seems feasible and safe, but its validity should be considered unverified.
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Affiliation(s)
- Fabio Crocerossa
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.,Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | | | - Umberto Carbonara
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA.,Unit of Andrology and Kidney Transplantation, Department of Urology, University of Bari, Bari, Italy
| | - Francesco Cantiello
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rocco Damiano
- Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Jose Rubio-Briones
- Department of Urology, Instituto Valenciano Oncologia (IVO) Foundation, Valencia, Spain
| | - Morgan Roupret
- Department of Urology, GRC5 Predictive Onco-Uro, AP-HP, Pitie-Salpetriere Hospital, Sorbonne University, Paris, France
| | - Alberto Breda
- Department of Urology, Puigvert Foundation, Autonomous University of Barcelona, Barcelona, Spain
| | - Alessandro Volpe
- Division of Urology, Department of Translational Medicine, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - M Carmen Mir
- Urology Department, IMED Hospitals, Valencia, Spain -
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Image-Guided Thermal Ablation in De Novo Renal Tumor Arising in Kidney Allograft: 3-Year Follow-Up. A Case Report. Transplant Proc 2021; 53:2539-2542. [PMID: 34315637 DOI: 10.1016/j.transproceed.2021.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 04/19/2021] [Accepted: 05/04/2021] [Indexed: 12/19/2022]
Abstract
De novo tumors in renal allograft recipients are a severe complication during long-term follow-up after transplantation and may require transplantectomy. Herein we present a case of de novo renal tumor arising in the renal allograft, treated with the less invasive image-guided radiofrequency ablation (RFA) with long-term follow-up. A tumor was detected during the routine annual follow-up in a patient with good renal function who underwent renal transplantation in 1989. Computed tomography (CT) showed a mass in the allograft whose shape, vascularization, and density suggested the presence of a solid, malignant mass, located in the upper renal pole, that measured 17 mm. CT-guided RFA was performed successfully, and the outcome was verified by an immediate control CT after the intervention. No residual pathologic tissue, major bleeding, or damage to the adjacent parenchyma was evidenced. The patient was discharged with stable renal function. CT scan and ultrasound were performed 3, 6, 12, 18, 24, and 36 months after RFA. No signs of change in renal function, recurrence, neovascularization, or damage to the adjacent microcirculation were observed during the 3-year follow-up. In conclusion, percutaneous RFA of small renal tumors occurring in renal allografts can be considered a function-sparing, safe, and effective therapeutic option when difficult surgical removal may be anticipated. Our experience also supports the need for yearly renal allograft ultrasound follow-up for early identification of small neoplasm than can be treated less invasively.
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Kidney Transplantation From Donors with Resectable Renal Cell Carcinoma: Two Case Reports. Transplant Proc 2020; 52:737-739. [PMID: 32139277 DOI: 10.1016/j.transproceed.2020.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 01/03/2020] [Accepted: 01/22/2020] [Indexed: 11/21/2022]
Abstract
BACKGROUND The existence of renal cell cancer (RCC) in a donated kidney may cause some confusion for clinicians. We aim to present our clinical experiences with 2 recipients who received an RCC-containing kidney from their living related donors. METHODS Two male patients received a kidney containing resectable size RCC from their living related donors. The recipients were discharged with well-functioning kidneys and currently are being monitored on standard follow-up protocols, and there is no evidence of RCC in their grafts. RESULTS The kidneys with resectable sizes of renal cell carcinoma were transplanted to the recipients after nephron-sparing surgery, with no sign of recurrent RCC in the 12-month follow-up period. CONCLUSIONS In the era of transplantation, the shortage of organ sources is the major barrier for the provision of organs to recipients. To enhance the graft donation pool, kidneys with resectable size RCC might be used in providing grafts to patients with end-stage kidney disease.
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Lim SY, Kim MG, Park KT, Jung CW. Experiences of renal transplants from donors with renal cell carcinoma after ex vivo partial nephrectomy. Ann Surg Treat Res 2017; 92:361-364. [PMID: 28480182 PMCID: PMC5416927 DOI: 10.4174/astr.2017.92.5.361] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/13/2016] [Accepted: 11/29/2016] [Indexed: 12/28/2022] Open
Abstract
Purpose Routine evaluation of kidney donors occasionally reveals an incidental renal mass with an otherwise satisfactory kidney function. The use of such a kidney with an enhancing mass for transplantation is a matter of debate owing to a possible risk of transmission of donor malignancies. We report our experience of kidney transplants from donors with renal cell carcinoma, after ex vivo resection of the renal mass. Methods Two women aged 44 and 56 years were diagnosed with enhancing renal masses measuring 0.9 cm and 0.7 cm, respectively, during donor evaluation for kidney transplantation. Both patients and their families were informed of a potential risk of recurrent renal cell carcinoma following transplantation. Results Renal function test results of both donors satisfied the living donor selection criteria. Laparoscopic live donor nephrectomy was performed with ex vivo resection of renal masses on the bench table. Immediate pathological analysis revealed a renal cell carcinoma with a margin of normal renal parenchyma before transplantation. Regimens based on mammalian target of rapamycin inhibitors, which are known for their antitumoral properties, were used for immunosuppression in both recipients. None of the recipients showed recurrence or metastasis during the follow-up period, which was longer than 3 years after transplantation. Conclusion In light of the ongoing shortage of kidney donors, kidneys with small renal cell carcinoma could be considered for transplantation after appropriate removal of the lesion, with a very low risk of recurrent disease.
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Affiliation(s)
- Sung Yoon Lim
- Department of Internal Medicine, Korea University Medical College, Seoul, Korea
| | - Myung Gyu Kim
- Department of Internal Medicine, Korea University Medical College, Seoul, Korea
| | - Kwon Tae Park
- Department of Surgery, Korea University Medical College, Seoul, Korea
| | - Cheol Woong Jung
- Department of Surgery, Korea University Medical College, Seoul, Korea
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Dhakal P, Giri S, Siwakoti K, Rayamajhi S, Bhatt VR. Renal Cancer in Recipients of Kidney Transplant. Rare Tumors 2017; 9:6550. [PMID: 28458790 PMCID: PMC5379230 DOI: 10.4081/rt.2017.6550] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 12/29/2016] [Accepted: 02/14/2017] [Indexed: 01/20/2023] Open
Abstract
The aim of our study is to determine characteristics and outcomes of kidney cancer in renal transplant recipients. MEDLINE® database was searched in June 2015 to identify cases of kidney cancer in renal transplant recipients. We include also a new case. Descriptive statistics were used for analysis. Forty-eight (48) recipients reported in 25 papers met the eligibility criteria. The median age was 47 years (range 9-66); 27% were females. Chronic glomerulonephritis, cystic kidney disease and hypertension were common indications for renal transplant. Among donors 24% were females and the median age was 52.5 years (17-73); 62% of kidney cancers were donor-derived. The median interval between transplant and cancer diagnosis was shorter for cancer of recipient versus donor origin (150 vs. 210 days). Clear cell carcinoma was diagnosed in 17%. 25% had metastasis at diagnosis. Kidney explantation or excision was done in 90% and 84% of cases with and without metastasis respectively. The median survival was 72 months. Actuarial 1-year and 5-year survival rates were 73.4% and 55.1% respectively. Among the recipients from 7 donors who subsequently developed malignancy, 57% were dead within a year. Kidney transplant recipients have a small risk of kidney cancer, which affects younger patients and occurs within a year of transplant, likely due to immunosuppression. Whether the use of older donors may increase the likelihood needs further investigation. The presence of metastasis, explantation or excision of affected kidney and development of cancer in donors predict outcomes. The results may guide patient education and informed decision-making.
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Affiliation(s)
| | - Smith Giri
- The Yale New Haven Hospital, New Haven, CT
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6
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Desai R, Neuberger J. Donor transmitted and de novo cancer after liver transplantation. World J Gastroenterol 2014; 20:6170-6179. [PMID: 24876738 PMCID: PMC4033455 DOI: 10.3748/wjg.v20.i20.6170] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2013] [Revised: 12/02/2013] [Accepted: 01/05/2014] [Indexed: 02/06/2023] Open
Abstract
Cancers in solid organ recipients may be classified as donor transmitted, donor derived, de novo or recurrent. The risk of donor-transmitted cancer is very low and can be reduced by careful screening of the donor but cannot be abolished and, in the United Kingdom series is less than 0.03%. For donors with a known history of cancer, the risks will depend on the nature of the cancer, the interventions given and the interval between diagnosis and organ donation. The risks of cancer transmission must be balanced against the risks of death awaiting a new graft and strict adherence to current guidelines may result increased patient death. Organs from selected patients, even with high-grade central nervous system (CNS) malignancy and after a shunt, can, in some circumstances, be considered. Of potential donors with non-CNS cancers, whether organs may be safely used again depends on the nature of the cancer, the treatment and interval. Data are scarce about the most appropriate treatment when donor transmitted cancer is diagnosed: sometimes substitution of agents and reduction of the immunosuppressive load may be adequate and the impact of graft removal should be considered but not always indicated. Liver allograft recipients are at increased risk of some de novo cancers, especially those grafted for alcohol-related liver disease and hepatitis C virus infection. The risk of lymphoproliferative disease and cancers of the skin, upper airway and bowel are increased but not breast. Recipients should be advised to avoid risk behavior and monitored appropriately.
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7
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Xiao D, Craig JC, Chapman JR, Dominguez-Gil B, Tong A, Wong G. Donor cancer transmission in kidney transplantation: a systematic review. Am J Transplant 2013; 13:2645-52. [PMID: 24034231 DOI: 10.1111/ajt.12430] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 07/03/2013] [Accepted: 07/05/2013] [Indexed: 01/25/2023]
Abstract
Transplantation of any biological material from a donor to a host will carry some inherent risk of disease transmission. Our aims were to summarize the totality of the published evidence about donor cancer transmission among kidney transplant recipients and to determine the cancer-specific survival of these patients. We systematically reviewed all case reports, case series and registry studies that described the outcomes of kidney transplant recipients with donor cancer transmission published to December 2012. A total of 69 studies with 104 donor-transmitted cancer cases were identified. The most common transmitted cancer types were renal cancer (n = 20, 19%), followed by melanoma (n = 18, 17%), lymphoma (n = 15, 14%) and lung cancer (n = 9, 9%). Patients with melanoma and lung cancers had the worst prognosis, with less than 50% of recipients surviving after 24 months from transplantation. Recipients with transmitted renal cancers had the best outcomes, with over 70% of recipients surviving for at least 24 months after transplantation. Overall, the risk of donor transmission of cancer appears low, but there is a high likelihood of reporting bias. Our findings support the current recommendations for rejecting organs from donors with a history of melanoma and lung cancer, but suggest that the use of donor kidneys with a history of small, incidental renal cell cancer may be reasonable.
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Affiliation(s)
- D Xiao
- Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia
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González-López R, Bueno-Serrano G, Vázquez-Escuderos JJ, Mayor-De Castro J, González-Enguita C. [Conservative treatment of renal cell carcinoma in kidney transplantation]. Actas Urol Esp 2013; 37:242-8. [PMID: 23246102 DOI: 10.1016/j.acuro.2012.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 07/09/2012] [Accepted: 07/28/2012] [Indexed: 01/15/2023]
Abstract
PURPOSE To evaluate the new treatment strategies in renal cell carcinoma (RCC) that affects the graft in renal recipients. ACQUISITION OF EVIDENCE A literature review is made, analyzing all the published cases of conservative surgery in renal graft RCC. SYNTHESIS OF EVIDENCE A total of 51 partial nephrectomies in renal graft patients have been described, with a graft survival rate of 88% and a recurrence rate of 6%. Most of the patients (75%) were asymptomatic at the time of diagnosis, and the mean lesion size was 2.8 cm. Enucleation was the most frequent technique employed. 77% of all immunosuppressor regimens included cyclosporine A. Six patients with graft RCC were subjected to radiofrequency ablation and two patients underwent percutaneous cryoablation, with a single case of relapse and a graft survival rate of 100%. CONCLUSIONS Nephron-sparing surgery is a good management option in renal graft RCC, affording good oncological control and graft survival. Modification of immunosuppression with the withdrawal of cyclosporine A and the introduction of mTOR inhibitors is an adequate measure in such patients.
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Affiliation(s)
- R González-López
- Servicio de Urología, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España.
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González-López R, Bueno-Serrano G, Vázquez-Escuderos J, Mayor-De Castro J, González-Enguita C. Conservative treatment of renal cell carcinoma in kidney transplantation. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.acuroe.2012.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Role of MDCT angiography in selection and presurgical planning of potential renal donors. AJR Am J Roentgenol 2013; 199:1035-41. [PMID: 23096176 DOI: 10.2214/ajr.11.8058] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purpose of this study was to determine the prevalence and types of renal and extrarenal abnormalities that preclude renal donation or lead to alteration of the surgical approach on the basis of abdominal CT angiography (CTA) in a large group of potential renal donors. MATERIALS AND METHODS In this retrospective study, 654 potential renal donors undergoing dual-phase CTA were identified from January 2005 to January 2009. The CT reports were systemically reviewed by two radiologists to determine the presence of renal and extrarenal abnormalities. The operative notes of the renal donors were reviewed by one radiologist to determine whether the presence of renal pathology had affected the surgical approach. In the candidates who did not proceed to kidney donation, the reasons that precluded kidney donation were abstracted from the transplant database. RESULTS Four hundred seventeen potential donors (269 men and 385 women; mean age, 44.0 years; age range, 17-79 years) proceeded to renal donation and 237 did not. The most common renal abnormalities were cysts (34%) and renal stones (4.4%). Renal artery disease was identified in 3.4% of potential donors, including renal artery stenosis, possible fibromuscular dysplasia, and renal artery aneurysm. Suspicious renal masses were incidentally found in 0.5% of potential donors. The most common extrarenal pathology was an incidental adrenal nodule (2.6%). Other significant extrarenal pathology identified included gallbladder mass (0.2%), Crohn disease (0.2%), ovarian mass (0.2%), and possible sarcoidosis (0.2%). Although renal and extrarenal abnormalities were present in 41% of potential renal donors, abnormalities seen on CT only contributed to exclusion of 27 potential donors (4.1%). The most common reason for exclusion was the presence of renal stones or scarring (1.8%). Significant CT findings also contributed to the selection of the right kidney in 29 donors, most commonly due to presence of ipsilateral vascular disease or complex left vascular anatomy. CONCLUSION Renal parenchymal and vascular abnormalities are common in asymptomatic potential kidney donors. Although most of these represent incidental CT findings, abnormalities can exclude potential renal donors and alter the surgical approach in a small minority of cases.
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Detection and management of renal cell carcinoma in the renal allograft. Int Urol Nephrol 2012; 45:93-8. [DOI: 10.1007/s11255-012-0274-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 08/20/2012] [Indexed: 12/20/2022]
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Organ donor found to have von Hippel-Lindau disease: case report. Transplant Proc 2011; 43:1438-40. [PMID: 21693214 DOI: 10.1016/j.transproceed.2010.12.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2010] [Accepted: 12/20/2010] [Indexed: 11/21/2022]
Abstract
Multiple pancreatic cyst in combination with central nervous system hemangioma may be associated with Von Hippel-Lindau disease. The disease manifests with other systemic benign and malignant lesions. The risk of associated malignancy makes it imperative to review target organs before proceeding to transplantation, but does not preclude it completely if proper evaluation is performed. We present a case of an organ donor found to have multiple pancreatic cysts. Evaluation and transplantation decisions are discussed.
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Khurram MA, Sanni AO, Rix D, Talbot D. Renal transplantation with kidneys affected by tumours. Int J Nephrol 2011; 2010:529080. [PMID: 21331315 PMCID: PMC3034927 DOI: 10.4061/2010/529080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2010] [Revised: 11/10/2010] [Accepted: 12/23/2010] [Indexed: 12/28/2022] Open
Abstract
Renal transplantation confers improvement in quality of life and survival when compared to patients on dialysis. There is a universal shortage of organs, and efforts have been made to overcome this shortage by exploring new sources. One such area is the use of kidneys containing small tumours after resection of the neoplasm. This paper looks at the current evidence in the literature and reviews the feasibility of utilizing such a source.
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Affiliation(s)
- Muhammad Arslan Khurram
- Department of Liver/Renal Transplant, Freeman Hospital Newcastle Upon Tyne NHS Foundation Trust, Newcastle Upon Tyne NE7 7DN, UK
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15
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Surgical Treatment of Renal Cell Carcinoma in the Immunocompromised Transplant Patient. Urology 2010; 75:1373-7. [DOI: 10.1016/j.urology.2009.06.085] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 05/21/2009] [Accepted: 06/06/2009] [Indexed: 11/24/2022]
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Llamas F, Gallego E, Salinas A, Virseda J, Pérez J, Ortega A, Nam SH, Gómez C. Sarcomatoid renal cell carcinoma in a renal transplant recipient. Transplant Proc 2009; 41:4422-4. [PMID: 20005414 DOI: 10.1016/j.transproceed.2009.08.066] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2009] [Revised: 06/10/2009] [Accepted: 08/17/2009] [Indexed: 12/17/2022]
Abstract
The incidence of transplanted kidneys derived from elderly donors is increasing because of the larger waiting lists and greater age of patients with end-stage renal failure. Compared with young donors, one of the problems is the heightened risk of neoplasm transmission. We report 2 cases of kidney recipients, both of whom developed a sarcomatoid renal cell carcinoma after receiving a kidney transplant from the same 68-year-old male donor, who did not show signs of a neoplasm on a previous abdominal ultrasound or a pretransplant biopsy. The first recipient was a 66-year-old woman who developed a kidney mass with several urologic obstructive complications, tumor dissemination, and death at 9 months after kidney transplantation. The second recipient was a 48-year-old asymptomatic man with normal renal function, who was studied after the results of the first recipient, revealing another renal tumor. Transplant nephrectomy was performed and a peritoneal implant was resected. The patient is alive without evidence of a neoplasm after 18 months. Herein we have discussed the mechanisms of neoplasm transmission in kidney transplantation and possible strategies for its prevention and treatment.
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Affiliation(s)
- F Llamas
- Department of Nephrology University Hospital of Albacete, Hnos Falce 37, Albacete 02006, Spain
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Diller R, Senninger N. Treatment options and outcome for renal cell tumors in the transplanted kidney. Int J Artif Organs 2009; 31:867-74. [PMID: 19009504 DOI: 10.1177/039139880803101002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The diagnosis of renal cell carcinoma in a transplanted kidney is rare but with possibly devastating consequences. In addition to transplant nephrectomy, which inevitably results in a return to dialysis, various treatment options such as different techniques for nephron sparing surgery and local ablative procedures (like radiofrequency ablation or cryoablation) have been described in the literature. An important issue is to find the balance between the preservation of the transplant function, on the one hand, which is dependent on the maintenance of an immunosuppressive regimen, and a sufficiently radical tumor therapy on the other hand. To provide an overview of current therapeutic attempts to cure transplant renal cell carcinoma under these conditions, published data on related therapies and outcomes are summarized.
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Affiliation(s)
- R Diller
- Department of General Surgery, University Hospital of Münster, Münster - Germany.
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18
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Kowal M, Hus M, Dmoszynska A, Kocki J, Grzasko N. Acute T cell lymphoblastic leukemia in the recipient of a renal transplant from a donor with malignant lymphoma. Acta Haematol 2008; 119:187-9. [PMID: 18536518 DOI: 10.1159/000137944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 03/21/2008] [Indexed: 11/19/2022]
MESH Headings
- Adult
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Clone Cells/pathology
- Clone Cells/transplantation
- Fatal Outcome
- Female
- Humans
- Immunophenotyping
- Immunosuppression Therapy/adverse effects
- In Situ Hybridization, Fluorescence
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/surgery
- Kidney Transplantation/adverse effects
- Leukemia-Lymphoma, Adult T-Cell/drug therapy
- Leukemia-Lymphoma, Adult T-Cell/etiology
- Leukemia-Lymphoma, Adult T-Cell/pathology
- Lymphoma, T-Cell/diagnosis
- Lymphoma, T-Cell/pathology
- Male
- Mediastinal Neoplasms/diagnosis
- Mediastinal Neoplasms/pathology
- Middle Aged
- Neoplasms, Unknown Primary/diagnosis
- Neoplasms, Unknown Primary/pathology
- Neoplastic Stem Cells/pathology
- Neoplastic Stem Cells/transplantation
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/etiology
- Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology
- Thymus Neoplasms/diagnosis
- Thymus Neoplasms/pathology
- Tissue Donors
- Transplantation, Homologous/adverse effects
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Affiliation(s)
- Malgorzata Kowal
- Department of Hematooncology and Bone Marrow Transplantationt, Medical University of Lublin, Lublin, Poland
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Mitsuhata N, Ito S, Mannami M, Kojima K, Mannami R, Nishi M. Donor Kidneys With Small Renal Cell Cancer or Low-Grade Lower Ureteral Cancer Can Be Transplanted. Transplantation 2007; 83:1522-3. [PMID: 17565330 DOI: 10.1097/01.tp.0000268482.48076.22] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gandhi MJ, Strong DM. Donor derived malignancy following transplantation: a review. Cell Tissue Bank 2007; 8:267-86. [PMID: 17440834 DOI: 10.1007/s10561-007-9036-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Accepted: 02/12/2007] [Indexed: 02/06/2023]
Abstract
Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the recent years, there has been an increasing demand for organs but not a similar increase in the supply leading to a severe shortage of organs for transplant resulted in increasing wait times for recipients. This has resulted in expanded donor criteria to include older donors and donors with mild disease. In spite of implementation of more stringent criteria for donor selection, there continues to be some risk of donor derived malignancy. Malignancy after transplantation can occur in three different ways: (a) de-novo occurrence, (b) recurrence of malignancy, and (c) donor-related malignancy. Donor related malignancy can be either due to direct transmission of tumor or due to tumor arising in cells of donor origin. We will review donor related malignancies following solid organ transplantation and hematopoeitic progenitor cell transplantation. Further, we will briefly review the methods for detection and management of these donor related malignancies.
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Affiliation(s)
- Manish J Gandhi
- Department of Pathology and Immunology, Washington University, 660 S Euclid Ave #8118, St Louis, MO 63110, USA.
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