Single center series: Tumor resected kidney transplant quality of life

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Ready to upload
Record number: 
2040
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
(Council of Europe, 2018): To provide a valid assessment, complete tumour resection (R0) prior to transplantation is required for the acceptance of all organs; additionally, tumour-free margins are a prerequisite for transplant of the affected kidney. The contralateral kidney should always be examined for synchronous RCC. RCC < 1 cm (Stage T1a AJCC 8th ed.) and nucleolar grade I/II (Fuhrman grade I/II) can be considered minimal risk for transmission. RCC 1-4 cm (Stage T1a AJCC 8th ed.) and nucleolar grade I/II (Fuhrman grade I/II) are considered low risk. RCC > 4-7 cm (Stage T1b AJCC 8th ed.) and nucleolar grade I/II (Fuhrman grade I/II) are considered intermediate risk. RCC > 7 cm (Stage T2 AJCC 8th ed.) and nucleolar grade I/II (Fuhrman grade I/II) are considered high risk. RCC with extension beyond the kidney (Stages T3 or T4 AJCC 8th ed.) is considered a contraindication to transplant. All RCC with nucleolar grade III/IV (Fuhrman grade III/IV) are considered high risk for transmission. Contralateral kidneys and other organs that are uninvolved by carcinoma are considered to represent minimal risk for transplantation when the RCC in the involved kidney is 4 cm or less and Fuhrman or nucleolar grade I-II. Followup surveillance is recommended. In the case of a donor with a history of renal cell carcinoma, the transmission risk of treated RCC depends on the 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 (no tumor transmissions)
Alerting signals, symptoms, evidence of occurrence: 
N/A (no tumor transmissions)
Demonstration of imputability or root cause: 
N/A No tumor transmissions
Imputability grade: 
0 Excluded
Groups audience: 
Suggest new keywords: 
Single center series
Malignancy
Living donor
Kidney transplant
Renal cell carcinoma
Suggest references: 
Sundararajan S, He B, Delriviere L. Tumor-resected kidney transplant- a quality of life survey. Transplant Research and Risk Management. 2016;8:9-13.
Note: 
Carl-Ludwig: agree to MIchael
Expert comments for publication: 
Quality of life study of 20 patients who received kidneys from live donors undergoing nephrectomy for renal cell carcinoma 3 cm diameter or less (27 patients given kidneys, 20 returned questionnaires). No tumor transmissions occurred 13-74 months posttransplant (median 38 month followup). All improved quality of life; one patient who preferred dialysis over transplant did so because of immunosuppression effects. Little to no concern for tumor recurrence among responders. All recipients were 60 years of age or older.