Lugo-Baruqui Jose A, Guerra Giselle, Chen Linda, Burke George W, Gaite Judith A, Ciancio Gaetano
The Lillian Jean Kaplan Renal Transplant Center of the Division of Transplantation, Miami, FL, USA.
Department of Surgery, University of Miami Miller School of Medicine and Miami Transplant Institute at the Jackson Memorial Hospital, Miami, FL, USA.
Transpl Int. 2015 Sep;28(9):1126-30. doi: 10.1111/tri.12594. Epub 2015 May 7.
To report our series of cases with living donor kidney transplant by laparoscopic nephrectomy with incidental renal cell carcinomas (RCC) at the time of transplant. We performed a search of cases of renal allografts from living donors with incidental tumors which were confirmed as RCC in final pathology. The graft nephrectomy was performed via hand-assisted laparoscopic procedure. All cases underwent partial nephrectomy of the tumor during the back-table preparation of the graft and sent for pathological analysis. We performed 435 living donor kidney transplants at our Institution and identified four cases consistent with the diagnosis of RCC. Two of them were clear cell type, one papillary and one multilocular RCC. All the tumors presented at stage I of TNM classification. After a median follow-up of 36 months, three patients remain free of dialysis with good allograft function. One noncompliant patient presented with a glomerular filtration rate (GFr) below 15 ml/min after a BK viral infection. At the end of follow-up period, all patients had remained free of tumor. Donors with suspicious renal masses might be accepted for living donation. Partial nephrectomy before transplantation could offer a cure for the disease without risks for the recipient with therapeutic benefit for the donor.
报告我们一系列通过腹腔镜肾切除术进行活体供肾移植且移植时伴有偶发性肾细胞癌（RCC）的病例。我们对活体供肾的肾移植病例进行了检索，这些病例伴有偶发性肿瘤，最终病理确诊为RCC。移植肾切除术通过手辅助腹腔镜手术进行。所有病例在移植肾的后台准备过程中均对肿瘤进行了部分肾切除术，并送去做病理分析。我们机构共进行了435例活体供肾移植，确定了4例符合RCC诊断的病例。其中2例为透明细胞型，1例为乳头状，1例为多房性RCC。所有肿瘤均为TNM分类的I期。中位随访36个月后，3例患者无需透析，移植肾功能良好。1例不依从患者在BK病毒感染后肾小球滤过率（GFr）低于15ml/min。随访期末，所有患者均无肿瘤复发。有可疑肾肿块的供体可能被接受进行活体捐赠。移植前进行部分肾切除术可为疾病提供治愈机会，对受体无风险，对供体有治疗益处。
