Status:
Ready to upload
Record number:
2081
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Renal angiomyolipoma is typically a benign tumor and incidental finding estimated to occur with a frequency between 0.02-0.2%. Frequency is higher in conditions of tuberous sclerosis or lymphangioleiomyomatosis ( https://www.kidney-international.org/article/S0085-2538(15)50139-7/ ) (fulltext). The Council of Europe does not discuss this lesion. It may rarely coexist with other renal cell neoplasms.
Time to detection:
At time of transplant - this report documents patients who received living donor kidneys with angioyolipomas discovered incidentally at the time of transplant. In some cases (where accessible- 2 cases) they were resected, in others (where they were deeper in the parenchyma- 4 cases) they were left intact and followed.
Alerting signals, symptoms, evidence of occurrence:
None.
Demonstration of imputability or root cause:
Documented in donors.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
References:
Suggest new keywords:
Malignancy
Single center series
Living donor
Kidney transplant
Angiomyolipoma (benign)
Kidney recipient
Kidney transplantation
Therapy not discussed
Reference attachment:
Suggest references:
Zahran MH, Kamal AI, Abdelfattah A, Mashaly ME, Fakhreldin I, Osman Y, Ali-El-Dein B. Outcome of Live-Donor Renal Transplants With Incidentally Diagnosed Renal Angiomyolipoma in the Donor. Transplant Proc. 2019 Jul-Aug;51(6):1773-1778. doi: 10.1016/j.transproceed.2019.02.035. Epub 2019 Jun 27. PMID: 31255355.
Note:
Second review MN 5/3/22
Expert comments for publication:
This retrospective study documented 6 donor angiomyolipomas in the setting of living kidney transplant. Sizes ranged from 0.5-2 cm. Two were resected prior to transplant, 4 left intact. Followup times ranged from 25-150 months. There was no evidence of increase in lesion size or development of new lesions in the grafts. The authors consider that this does not represent a contraindication to transplant and also suggest consideration of everolimus or sirolimus based regimens which they note have been associated with reduction in lesion size in the setting of tuberous sclerosis or lymphangioleiomyomatosis (Bissler et al. Lancet 2013;381:817-24).