Kidneys With Small Renal Cell Carcinoma Used in Transplantation After Ex Vivo Partial Nephrectomy

Background: The increase in the prevalence of end-stage renal disease in developed countries and the shortage of deceased donors have made it necessary to increase the graft pool by means of several strategies, such as living donation, non-heart-beating organ donors, and expanded-criteria donors. This study aimed to assess the short-term outcomes of donor kidneys with small (≤3.5 cm) renal cell carcinoma (sRCC) and to evaluate the possibility of using marginal kidneys in renal transplantation.

Methods: Patients undergoing nephrectomy for sRCC who agreed to donate their kidneys were enrolled in the study. Seven dialysis patients aged 27-54 years agreed to undergo transplantation with sRCC kidneys. All of the transplantations were performed in Shandong Province Qianfoshan Hospital from May 2012 to March 2017. The function of transplanted kidneys was evaluated after surgery by testing and comparing parameters such as creatinine clearance rate, delayed graft function, and tumor recurrence.

Results: The graft function of the transplanted kidneys was recovered to normal in all of the 7 patients who received sRCC kidneys. The latest serum creatinine levels before publication ranged from 59 to 102 μmol/L in the 7 recipients (normal range of serum creatinine: men, 54-106 μmol/L; women, 44-97 μmol/L). No tumor recurrence was noted 31-58 months after surgery in the recipients.

Conclusions: According to short-term follow up (3-5 years), kidney transplantation in selected patients can be considered for kidneys having small incidental tumors. The use of marginal organs, such as those with sRCC, can increase the donor pool for kidney transplantation.