Royal Free Hospital, London, UK.
Curr Opin Urol. 2011 Sep;21(5):380-5. doi: 10.1097/MOU.0b013e328349638e.
To increase the number of patients who could benefit from renal transplantation new strategies need to be considered. The potential utility of kidneys found to contain small renal tumours has been proposed and is reviewed.
Successful outcomes have been observed using kidneys from deceased and live donors following excision of small incidentally detected renal cell carcinoma (RCC). In patients electing radical nephrectomy for small renal masses, the kidney, following excision of the tumour can be used as a novel form of altruistic organ donation. With these donor sources, the risk of tumour recurrence is extremely low with patient survival significantly better than the alternative of long-term dialysis and graft outcomes similar to other sources of donor organs.
Although controversial, the presence of a small renal tumour should not prevent transplantation of a kidney from either deceased or potential live donors. In circumstances, where patients elect for radical nephrectomy for small tumours, these kidneys should be considered for patients who may not otherwise have the opportunity of renal transplantation.
为了让更多的患者受益于肾移植,需要考虑新的策略。本文对发现含有小肾肿瘤的肾脏的潜在应用进行了综述。
成功地从已故和活体供者的肾脏中切除小的偶然发现的肾细胞癌(RCC)后,已经观察到了成功的结果。对于选择根治性肾切除术治疗小的肾肿瘤的患者,切除肿瘤后的肾脏可以作为一种新的利他性器官捐献形式。对于这些供者来源,肿瘤复发的风险极低,患者的生存率明显优于长期透析的替代方案,并且移植物的结局与其他供者器官来源相似。
尽管存在争议,但小的肾肿瘤的存在不应阻止从已故或潜在的活体供者移植肾脏。在患者选择根治性肾切除术治疗小肿瘤的情况下,这些肾脏应考虑用于那些否则可能没有肾移植机会的患者。