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Ready to upload
Record number:
1785
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
(Council of Europe, 2022): To provide valid histological staging, complete tumour resection (R0) is required for acceptance of all organs; additionally, tumour-free margins are a prerequisite for transplant of the affected kidney. Paraffin section is superior to frozen section for the assessment of such biopsies. The contralateral kidney should always be examined for synchronous RCC (5 % of patients). RCC < 1 cm (stage T1a AJCC 8th edn) and WHO/ISUP grade I/II (Fuhrman grade I/II) can be considered minimal-risk for transmission; RCC 1-4 cm (stage T1a AJCC 8th edn) and WHO/ISUP grade I/II (Fuhrman grade I/II) are considered low-risk; RCC > 4-7 cm (stage T1b AJCC 8th edn) and WHO/ISUP grade I/II (Fuhrman grade I/II) are considered intermediate-risk; RCC > 7 cm (stage T2 AJCC 8th edn) and WHO/ISUP grade I/II (Fuhrman grade I/II) are considered high-risk; RCC with extension beyond the kidney (stages T3/T4 AJCC 8th edn) is considered a contraindication to transplant; All RCC with WHO/ISUP grade III/IV (Fuhrman grade III/IV) are considered high-risk for transmission; Contralateral kidneys and other organs that are un¬involved in carcinoma are considered to represent minimal risk for transplantation when the RCC in the involved kidney is 4 cm or less and WHO/ISUP grade I-II. In all cases, follow-up surveillance is desirable.
RCC in the donor history: The transmission risk of treated RCC depends on the histological type of tumour [159] and its recurrence-free follow-up period. In general, in the first 5 years after initial diagnosis, risk categories correspond to those stated above (RCC diagnosed during donor procurement) if there is no suspicion of tumour recurrence in the donor. After this time, the risk of advanced stages may decrease.
Time to detection:
N/A: Review article
Alerting signals, symptoms, evidence of occurrence:
N/A: Review article
Demonstration of imputability or root cause:
N/A: Review article
Imputability grade:
Not Assessable
Groups audience:
Suggest new keywords:
Malignancy
renal cell carcinoma
renal transplant
subject review
Reference attachment:
Suggest references:
Khurram MA, Sanni AO, Rix D, Talbot D. Renal transplantation with kidneys affected by tumours. Int J Nephrol. Hindawi Publishing Corporation; 2011 Jan 18;2010(5):529080–6.
Note:
First review done 5/20/18. Second review 5/30/18.
Expert comments for publication:
2010 Review article in which the authors conclude that a) donor kidneys with small renal cell carcinomas can be considered for transplantation, b) partial nephrectomy can be considered for treatment of some renal cell carcinomas that are discovered in recipients after transplant, c) the contralateral kidney from donors with small renal cell carcinomas can be considered for transplantation. An interesting sidelight is a small survey taken in the UK in regard to supporting the use of kidneys with small renal cancers for transplantation. This approach was supported by 59% of potential recipients on the wait list (n=113), 72% of transplant surgeons (n=43), 78% of nephrologists (n=94) and 93% of potential donors who had a previous nephrectomy for renal cell carcinoma (n=15).