Treatment options for renal cell carcinoma in renal allografts: A case series from a single institution
Wake Forest School of Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA.Clinical Transplantation (Impact Factor: 1.52). 02/2013; 27(2). DOI: 10.1111/ctr.12088
Renal cell carcinoma (RCC) is more common in renal transplant and dialysis patients than the general population. However, RCC in transplanted kidneys is rare, and treatment has previously consisted of nephrectomy with a return to dialysis. There has been recent interest in nephron-sparing procedures as a treatment option for RCC in allograft kidneys in an effort to retain allograft function. Four patients with RCC in allograft kidneys were treated with nephrectomy, partial nephrectomy, or radiofrequency ablation. All of the patients are without evidence of recurrence of RCC after treatment. We found nephron-sparing procedures to be reasonable initial options in managing incidental RCCs diagnosed in functioning allografts to maintain an improved quality of life and avoid immediate dialysis compared with radical nephrectomy of a functioning allograft. However, in non-functioning renal allografts, radical nephrectomy may allow for a higher chance of cure without the loss of transplant function. Consequently, radical nephrectomy should be utilized whenever the allograft is non-functioning and the patient's surgical risk is not prohibitive.
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ABSTRACT: Thousands of patients with renal disease are on waiting lists for kidney transplant. Survival and quality of life on hemodialysis is much lower than that after renal transplantation. Renal allografts are extremely valuable and worth saving at all costs. Many complications can be seen after organ transplants on short and long term as rejection, vascular compromise and infection. There are various reports on partial nephrectomy after renal transplant secondary to de novo masses in the renal allograft. Here we present a case where we used radiofrequency bipolar sealer for partial nephrectomy for necrotic abscess of the renal allograft. We successfully saved the allograft with partial nephrectomy despite parenchymal infection and necrosis.ASAIO journal (American Society for Artificial Internal Organs: 1992) 03/2014; 60(3). DOI:10.1097/MAT.0000000000000066 · 1.52 Impact Factor
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ABSTRACT: The development of de novo renal cell carcinoma (RCC) in a transplanted kidney is a rare condition. Currently, this is the second case report of a 41-year-old man in whom carcinoma of a renal allograft was detected by contrast-enhanced ultrasound (CEUS). An abdominal CT scan was not conclusive enough to differentiate between septal enhancement of a cyst and a low vascularized tumor. CEUS confirmed a solid, homogeneously enhancing but hypoechoic and hypovascular lesion compared to the surrounding kidney parenchyma without septal enhancement. Therefore, the patient underwent nephron-sparing surgery (NSS), affirming papillary RCC type 2. Graft function remained unchanged postoperatively; 12 months after NSS, no local recurrence or distant metastasis was described. CEUS seems to be a minimally invasive and efficient imaging option if other diagnostic tools cannot clearly exclude RCC, with the advantage of wide-ranging use, especially in cases of impaired renal function. © 2014 S. Karger AG, Basel.Urologia Internationalis 08/2014; 93(3). DOI:10.1159/000362422 · 1.43 Impact Factor
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