Indian Journal of Urology
UROSCAN
Year
: 2009  |  Volume : 25  |  Issue : 2  |  Page : 278--279

Transplantation of kidneys with small renal tumors: A novel idea?


Sameer Grover, Samiran Das Adhikary, Nitin Kekre 
 Department of Urology, Christian Medical College, Vellore-632 004, Tamilnadu, India

Correspondence Address:
Sameer Grover
Department of Urology, Christian Medical College, Vellore-632 004, Tamilnadu
India




How to cite this article:
Grover S, Adhikary SD, Kekre N. Transplantation of kidneys with small renal tumors: A novel idea?.Indian J Urol 2009;25:278-279


How to cite this URL:
Grover S, Adhikary SD, Kekre N. Transplantation of kidneys with small renal tumors: A novel idea?. Indian J Urol [serial online] 2009 [cited 2021 Sep 19 ];25:278-279
Available from: https://www.indianjurol.com/text.asp?2009/25/2/278/52915


Full Text

 Summary



The authors in this case series reviewed their single-center experience with transplantation of kidneys removed from patients with small ( [1],[2] Until the availability of biological markers it would be very difficult to substantiate transplanting such kidneys. Secondly, this study includes patients from 1996-2004, a time when RN was the accepted modality of treatment for even small presumed RCCs. The concepts in the last few years have changed and tilted the best practice recommendation toward nephron sparing surgery. This is because up to 30% of such small lesions can be benign making RN superfluous. [3] With the high sensitivity of USG/CT guided FNAC/FNAB establishment of diagnosis of malignancy is warranted before intervention. Also, patients with RCC are at an increased risk of chronic kidney disease. [4] Radical nephrectomy was proven in a study from Sloan-Kettering Memorial Cancer center to be an independent predictor of a low GFR ( 2 ). In light of these new findings nephron sparing surgery should be offered to those in whom surgical removal of lesions is contemplated. Thirdly, there is a potential for misuse of these patients with a shift of focus from being renal tumor patients to being prospective donors. It could lead to a potential market resulting in indiscriminate RNs for financial/personal gains. Ethical considerations and informed consenting, especially in a country like ours, would be difficult to enforce and patient preference would be used as an excuse for such practices. Lastly, as such there is increased incidence of RCC in allograft recipients up to 100 times more than in the general population. [5] Transplantation of kidneys with proven RCC may increase the incidence of recurrence or metastasis even more. Though there appears to be a reasonable oncological and safety profile for recipients in the present study there are overwhelming considerations of this approach of stretching the donor pool a bit too far.

References

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