Ambrosi Francesca, Ricci Costantino, Malvi Deborah, Cillia Carlo De, Ravaioli Matteo, Fiorentino Michelangelo, Cardillo Massimo, Vasuri Francesco, D'Errico Antonia
Pathology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Emilia-Romagna Transplant Reference Centre, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Kidney Res Clin Pract. 2020 Dec 31;39(4):487-494. doi: 10.23876/j.krcp.20.050.
We report the findings of a single Italian center in the evaluation of renal lesions in deceased donors from 2001 to 2017. In risk evaluation, we applied the current Italian guidelines, which include donors with small (< 4 cm, stage pT1a) renal carcinomas in the category of non-standard donors with a negligible risk of cancer transmission.
From the revision of our registries, 2,406 donors were considered in the Emilia Romagna region of Italy; organs were accepted from 1,321 individuals for a total of 3,406 organs.
The evaluation of donor safety required frozen section analysis for 51 donors, in which a renal suspicious lesion was detected by ultrasound. Thirty-two primary renal tumors were finally diagnosed: 26 identified by frozen sections and 6 in discarded kidneys. The 32 tumors included 13 clear cell renal cell carcinomas (RCCs), 6 papillary RCCs, 6 angiomyolipomas, 5 oncocytomas, 1 chromophobe RCC, and 1 papillary adenoma. No cases of tumor transmission were recorded in follow-up of the recipients.
Donors with small RCCs can be accepted to increase the donor pool. Collaboration in a multidisciplinary setting is fundamental to accurately evaluate donor candidate risk assessment and to improve standardized protocols for surgeons and pathologists.
我们报告了意大利一家单一中心在2001年至2017年期间对已故供体肾脏病变评估的结果。在风险评估中，我们应用了当前的意大利指南，该指南将患有小肾癌（<4 cm，pT1a期）的供体归为非标准供体类别，其癌症传播风险可忽略不计。
通过对我们登记处的修订，在意大利艾米利亚-罗马涅地区考虑了2406名供体；接受了1321人的器官，共计3406个器官。
对51名供体的评估需要进行冰冻切片分析，这些供体通过超声检测到肾脏有可疑病变。最终诊断出32例原发性肾脏肿瘤：26例通过冰冻切片确定，6例在废弃肾脏中发现。这32例肿瘤包括13例透明细胞肾细胞癌（RCC）、6例乳头状RCC、6例肾血管平滑肌脂肪瘤、5例嗜酸细胞瘤、1例嫌色性RCC和1例乳头状腺瘤。在受者随访中未记录到肿瘤传播病例。
患有小肾癌的供体可以被接受以增加供体库。在多学科环境中的合作对于准确评估供体候选者的风险评估以及改进外科医生和病理学家的标准化方案至关重要。
