Evans D B, Calne R Y
Br Med J. 1974 Oct 19;4(5937):134-6. doi: 10.1136/bmj.4.5937.134.
Four patients in terminal renal failure who had various malignant tumours were treated by haemodialysis and cadaveric renal transplantation. One patient with a testicular seminoma and one with leiomyosarcomatous changes in polycystic kidneys were successfully grafted after removal of the tumours and both were healthy at three and two-and-a-half years afterwards without evidence of recurrence of tumour.One patient with an invasive carcinoma of the renal pelvis was successfully transplanted and remained well for eight months but rapidly deteriorated and died of extensive metastases. Another patient with a malignant melanoma died more than one year after unsuccessful grafting.The presence of concomitant malignant disease in patients with chronic renal failure need not necessarily exclude them from the chance of long-term treatment, including renal transplantation. Each patient should be considered individually from the point of view of the nature of the malignancy, its duration, and treatment.
4例终末期肾衰竭合并各种恶性肿瘤的患者接受了血液透析和尸体肾移植治疗。1例睾丸精原细胞瘤患者和1例多囊肾发生平滑肌肉瘤样改变的患者在肿瘤切除后成功接受了移植,术后3年和2年半时均健康,无肿瘤复发迹象。1例肾盂浸润性癌患者成功接受了移植,术后8个月情况良好,但随后病情迅速恶化,死于广泛转移。另1例恶性黑色素瘤患者在移植失败1年多后死亡。慢性肾衰竭患者合并恶性疾病不一定排除其接受长期治疗(包括肾移植)的机会。应根据恶性肿瘤的性质、病程和治疗情况对每例患者进行个体化评估。