OBJECTIVES: Kidneys after nephrectomy for small renal tumor have been considered as a potential source for solving the organ donor shortage. Buell, Mannami, Nicol, Meng, and He reported various cases using kidneys after tumor resection. Nalesnik placed small renal cell carcinoma (RCC) into the low-risk category of cancer transmission. So we have performed two prospective clinical trials that utilize restored kidneys after resection of renal tumor for transplanting into unrelated recipients and diseased kidneys into related recipients.
METHODS: Our study has an estimated enrollment of 20 cases (trial for unrelated) and 10 cases (trial for related) with one year of follow-up and was approved by Tokushukai Joint Ethics Committee and registered with U.S. ClinicalTrials.gov. Donors opted to undergo nephrectomy for small tumor and live related donor nephrectomy for diseased kidney. After nephrectomy, the restored kidney was transplanted into unrelated and related recipients.
RESULTS: A total of 11 unrelated donor patients and two related donors had renal tumors in donor kidneys consisted of RCC in 12 cases and AML in one. A total of 76 dialysis patients were enrolled as candidates for unrelated transplant. Unrelated transplant was performed in 11 patients including 4 with a history of transplant and related transplant in 2 patients. All patients received initially triple immunosuppression. Nine recipients experienced rejection episodes and the latest serum creatinine levels ranged from 1.08 to 2.68 mg/dl at 6-38 months after transplant. One related recipient died suddenly with functioning graft at 2 months, and the other 12 recipients are free from recurrence of RCC with good functioning graft.
CONCLUSIONS: Selected candidates can benefit from restored kidney transplant, achieving good renal function without recurrence of RCC. Candidates for related and unrelated transplant may benefit from accepting discarded kidneys with small RCC leading to a shorter waiting time on dialysis.
To cite this abstract in AMA style:Ogawa Y, Kobayashi T, Shiroma S, Kojima K, Mannami R, Mannami M, Kitajima K, Nishi M, Tamaki M, Afuso H, Ito S, Mituhata N. Restored Kidney Transplant after Resection of Small Renal Tumor into Unrelated and Related Recipients: Updated Results of Clinical Trials [abstract]. Am J Transplant. 2013; 13 (suppl 5). https://atcmeetingabstracts.com/abstract/restored-kidney-transplant-after-resection-of-small-renal-tumor-into-unrelated-and-related-recipients-updated-results-of-clinical-trials/. Accessed October 25, 2020.
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