*Purpose: End-stage renal disease (ESRD) is a risk factor for development of acquired cystic kidney disease (ACKD) with the incidence of ACKD rising from <10% to 20% 3 yrs after initiation of RRT and >90% of pts who have been on RRT for >5 yrs. Renal cell carcinoma (RCC) prevalence is higher in pts w/ ACKD (2-5%) and is potentially curable when localized to the kidney. Kidney transplant (KT) is also associated w/ an increased malignancy risk. There are currently no standard recommendations regarding surveillance for ACKD/RCC. We explore the attitudes of nephrologists, transplant surgeons, and urologists regarding renal imaging for pts w/ ESRD being evaluated for KT.

*Methods: We conducted a 30-question online survey distributed to members of the American Society of Transplant Surgeons (ASTS) from October to November 2018. The scope of the survey was to identify current knowledge about ACKD and practice patterns of screening for ACKD before and after KT.

*Results: During the period of study 20 respondents completed surveys. The majority of respondents had > 15 yrs of clinical experience, practiced in transplant centers performing >100 KT annually. Sixty-five percent stated their KT center routinely screens pts active on the KT list for ACKD, and of these, Sixty percent stated screening is performed at least every 2 to 5 yrs while on the list, with screening done primarily by renal ultrasound. Fifty-five percent stated that any size mass prompted referral to a urologic oncologist. Reasons not to transplant included recommendation of urologist, renal mass biopsy result, and size of renal mass. Fifty-five percent also stated that they actively list pts w/ renal masses w/out a tissue diagnosis. Forty percent require a nephrectomy with or without renal mass biopsy for active KT listing. Forty-five percent have a center policy to monitor renal masses pre-KT, and 20% have a screening policy post-KT.

*Conclusions: There is a heterogeneity of approaches for screening for ACKD, suggesting a need for further study regarding screening practices for patients with ESRD and outcomes following kidney transplantation.

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