Department of Surgery, New York-Presbyterian Hospital/Weill Cornell Medicine, New York, New York, USA.
J Endourol. 2021 Jul;35(7):1001-1005. doi: 10.1089/end.2020.0841. Epub 2020 Dec 31.
Kidney transplant candidates are occasionally found during the pre-transplant evaluation to have a suspicious mass in a native kidney. Further work-up and management of such a mass may delay transplantation for several months, which may create logistic barriers to transplant, particularly if there are timing constraints of the donor. In this study, we report our experience with simultaneous living donor kidney transplant and laparoscopic native nephrectomy, where the indication for nephrectomy was a suspicious lesion. We performed a retrospective review of patients who underwent simultaneous kidney transplant and native nephrectomy using prospectively collected data. We analyzed relevant patient characteristics, surgical details, pathologic results, and long-term follow-up. We identified 16 patients who underwent simultaneous living donor kidney transplantation and laparoscopic native nephrectomy at our institution between 2013 and 2018. Ten (62.5%) patients were found to have renal-cell carcinoma (RCC) on the final pathology. No patients had recurrent RCC, at a median follow-up of 4 years. For patients who are planning to undergo a living donor kidney transplant and are found to have a small mass that is suspicious for RCC, a simultaneous living donor kidney transplant and laparoscopic native nephrectomy is a possible approach in selected patients.
肾移植候选人在移植前评估中偶尔会发现其原肾有可疑肿块。进一步的检查和处理这种肿块可能会使移植延迟数月，这可能会给移植带来后勤障碍，特别是如果供体存在时间限制的话。在这项研究中，我们报告了我们同时进行活体供肾移植和腹腔镜下原肾切除术的经验，原肾切除术的指征是可疑病变。我们对 2013 年至 2018 年间在我们机构接受同时进行活体供肾移植和腹腔镜下原肾切除术的患者进行了回顾性分析，使用前瞻性收集的数据。我们分析了相关的患者特征、手术细节、病理结果和长期随访。我们确定了 16 名患者在我们机构接受了同时进行的活体供肾移植和腹腔镜下原肾切除术。最终病理检查发现 10 名（62.5%）患者患有肾细胞癌（RCC）。在中位数为 4 年的随访中，没有患者出现 RCC 复发。对于计划接受活体供肾移植且发现疑似 RCC 的小肿块的患者，对于选择的患者来说，同时进行活体供肾移植和腹腔镜下原肾切除术是一种可行的方法。
