Increasing kidney grafts for transplantation
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ORIGINAL ARTICLE
Increasing kidney grafts for transplantation Mireia Musquera1 · Alba Sierra1 · Fritz Diekmann2 · Meritxell Perez4 · Claudia Mercader · Lluis Peri1 · Nuria Esforzado2 · David Paredes3 · Antonio Alcaraz1 Received: 25 June 2020 / Accepted: 18 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction The current pool of organs available for transplantation does not cover requirements, for this reason nonstandard risk donors need to be incorporated into the pool. In this way, donors with small renal tumour are considered for transplantation after bench tumour excision. The aim of our study was to analyse our experience in using these grafts for transplantation. Materials and methods Retrospective analysis from our prospective accrued database of donors with incidental renal mass used for kidney transplantation between January 2007 and August 2018. Results Twenty kidney transplantations were performed, thirteen cases received the affected kidney (after tumour removal) and seven the contralateral kidney; from six living and eleven deceased donors. Donor and recipient median age was 58 years (range 22–82) and 56.5 years (range 38–74), respectively. Mean tumour diameter was 12.7 mm (SD 9.5). Tumours resulted in two benign lesions and fifteen renal cell carcinoma. Surgical margins were negative. Two cases presented with bleeding after reperfusion was solved without repercussion. One case presented with immediate vein thrombosis. None of them present delayed graft function. After a 69 month follow-up none of the donors or the recipients presented tumour recurrence. Conclusions Kidneys with small incidental tumours seem to be a good option for kidney transplantation in selected patients after bench surgery excision with good functional and oncologic results. More studies and longer follow-up are needed to confirm these results. Keywords Kidney transplant · Grafts · Renal tumour · Non-standard risk donors Abbreviations DCD Donation after death determined by circulatory criteria ECD Expanded-criteria donors RCC Renal cell carcinoma ESRD End stage renal disease
* Mireia Musquera [email protected] 1
Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Urology, Villarroel 170, 08036 Barcelona, Spain
2
Hospital Clinic de Barcelona, Instituto Clínic de Nefrología y Urología, Nefrology, Villarroel 170, 08036 Barcelona, Spain
3
Hospital Clinic de Barcelona, Coordination Unit, Villarroel 170 Barcelona, 08036 Catalunya, Spain
4
Hospital de Terrassa. Torrebonica, s/n, 08227 Terrassa, Barcelona, Spain
Introduction Several studies have shown that early renal transplantation improves quality of life and life expectancy compared with dialysis treatment by significantly reducing cardiovascular morbidity [1]. The scarcity of organs for transplantation has pushed professionals to look for new strategies to increase organ availability, including living donation, donation after death determined by circulatory criteria (DCD) and the use of
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