Status:
Ready to upload
Record number:
2191
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 no transmission
Alerting signals, symptoms, evidence of occurrence:
N/A
Demonstration of imputability or root cause:
The tumor was resected prior to transplant
Imputability grade:
0 Excluded
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Case Report
Living donor
Kidney transplant
Kidney recipient
Kidney transplantation
Renal cell carcinoma
Therapy not discussed
Reference attachment:
Suggest references:
Tran AP, Martins PN, Papazian ZG, Vanguri VK, Movahedi B, Fan PY, Bodziak KA, Yates JK, Sokoloff MH, Bozorgzadeh A. Transplantation of Renal Allograft After Removal of Renal Cell Carcinoma: Case Report and Review of the Literature. Exp Clin Transplant. 2021 Jul;19(7):732-735. doi: 10.6002/ect.2018.0215. Epub 2019 Oct 1. PMID: 31580237.
Note:
upload MN 5/8/22
first review MN 5/13/22
second review CLFF 5/19/22 (for Kerstin): agree to review, internal note: we have now many records and data without transmission event, but it will be a question of time when we have the frist case either with donor derived or donor transmission as this is not definitively excluded. Therefore discussion as shonw in record 2102 and systematic collection of data globally to achieve a sufficient number of cases is necessary (maybe I missed a review about this).
Expert comments for publication:
This 31 year old living donor provided a kidney for her father. A 1.0 cm chromophobe renal cell carcinoma was found at time of transplant and excised prior to implantation. No tumor has occurred in the recipient and no recurrence was found in the donor after 38 months of followup. The authors point out that chromophobe RCC without necrosis or sarcomatoid morphology has a better prognosis than clear cell or papillary RCC. This case report is consistent with current thinking that excision of small renal cell carcinomas prior to transplant is a viable procedure that is associated with minimal tumor transmission risk.