Living donor renal transplantation with incidental renal cell carcinoma from donor allograft.

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.