02083nas a2200181   4500008003900000245011200039210006900151260000800220300000700228490000800235520153900243100001301782700001401795700001701809700001501826700001501841856004501856       2009                          d00aLiving-donor renal transplantation of grafts with incidental renal masses after ex-vivo partial nephrectomy0 aLivingdonor renal transplantation of grafts with incidental rena  cDec  a550 v1043 aOBJECTIVES:  To assess transplantation of high-risk kidneys with incidental renal masses (found occasionally during the routine evaluation of a living kidney donor) into recipients with limited life-expectancy on haemodialysis, as this offers a potential solution to the current organ deficit. PATIENTS AND METHODS:  We detected five small (<2.3 cm), incidental, enhancing renal masses during donor evaluation. All patients had a standard metastatic evaluation. After laparoscopic donor nephrectomy a back-table partial nephrectomy was performed and frozen-section analysis was used to confirm both the diagnosis and negative surgical margins before transplantation. RESULTS:  Renal cell carcinoma was found in three of the five masses (one each cystic, clear cell and papillary; Fuhrman grades II, II and III, respectively) and the other two patients had angiomyolipoma. There were no long-term complications in the transplanted kidneys. One patient developed delayed acute humoral rejection after transplantation and was treated appropriately. Both donor and recipient were followed with periodic imaging. At a median (range) last follow-up of 15 (1-41) months, four patients were alive and one had died from complications after a fall. The cancer-specific survival was 100%. There was no evidence of local recurrence in any patient at the last follow-up. CONCLUSION:  Live donor kidneys with incidental small renal masses might be acceptable for transplantation in high-risk recipients after careful back-table partial nephrectomy.1 aSener, A1 aUberoi, V1 aBartlett, ST1 aKramer, AC1 aPhelan, MW  uhttps://notifylibrary.org/reference/4830