Vasisth Gaurav, Kapoor Anil, Piercey Kevin, Lambe Shahid
Department of Urology, McMaster University, Hamilton, Ontario, Canada.
Urol Ann. 2018 Apr-Jun;10(2):229-232. doi: 10.4103/UA.UA_66_17.
Renal cell carcinoma (RCC) in transplanted kidneys has been reported sporadically with incidence of about 0.5%. There are currently no standard guidelines on the management of allograft RCC in renal transplant recipients. Our objective was to study effectiveness of nephron-sparing surgery (NSS) for allograft RCC. We performed a retrospective analysis of patients with RCC in renal allografts managed with NSS in our institution from January 2000 to December 2015. Patient demographics, interval between transplant and RCC diagnosis, operative parameters, perioperative complications, final pathology, and renal function were evaluated. Three females underwent successful NSS for allograft RCC. Cause of end-stage renal disease was IgA nephropathy in all; mean time between renal transplant and diagnosis of RCC was 23 years. We were able to stay extraperitoneal in all the cases. In the final pathology, two had papillary and one had clear cell RCC. One patient developed pyelocutaneous fistula which was managed by stenting. Long-term functional outcomes of NSS are excellent; none of our patients is dialysis dependent.
移植肾肾细胞癌(RCC)已有零星报道,发病率约为0.5%。目前对于肾移植受者同种异体移植肾RCC的治疗尚无标准指南。我们的目的是研究保留肾单位手术(NSS)治疗同种异体移植肾RCC的有效性。我们对2000年1月至2015年12月在我们机构接受NSS治疗的同种异体移植肾RCC患者进行了回顾性分析。评估了患者的人口统计学特征、移植与RCC诊断之间的间隔、手术参数、围手术期并发症、最终病理结果和肾功能。三名女性同种异体移植肾RCC患者成功接受了NSS。所有患者终末期肾病的病因均为IgA肾病;肾移植与RCC诊断之间的平均时间为23年。所有病例均成功采用腹膜外入路。最终病理结果显示,两名患者为乳头状RCC,一名患者为透明细胞RCC。一名患者发生肾盂皮肤瘘,通过置入支架进行处理。NSS的长期功能预后良好;我们的患者均无需依赖透析。