Kidneys with small tumors okay for transplantation

Kidneys with small tumors okay for transplantation

NEW YORK (Reuters Health) - The availability of kidneys for
transplantation could be increased by using kidneys removed for small,
incidentally detected tumors, the results of an Australian study suggest.

The biggest challenge in kidney transplantation is the shortage of donor
organs, note Dr. David L. Nicol, from Princess Alexandra Hospital in
Brisbane, and colleagues. Use of "marginal" kidneys from deceased donors
has been one strategy employed to address this problem, but research has
shown that outcomes are generally enhanced with live donor kidneys, even
from genetically unrelated donors.

For many patients, there is no suitable live donor, they explain. This is
particularly problematic for older patients or those with more than one
illness who may die while waiting for a donor organ from a person who has
died.

Nicol's team studied the outcomes of 43 patients who received kidneys that
had contained small, incidentally detected tumors.

The organs had come from 38 patients who had a kidney removed for presumed
renal cell cancer and from 3 deceased donors. After surgery to remove the
tumor, all the kidneys were successfully transplanted.

Most of the recipients were over 60 years and many had multiple illnesses.
Four patients died from unrelated causes. All of the remaining patients
had a functioning kidney during the 32 months they were followed.

Surveillance tests performed every 3 months revealed tumor recurrence in
one patient. This recurrence occurred 9 years after transplantation and
the patient has been stable for the last 18 months, the investigators
report.

"Our experience," they conclude, "suggests that kidneys from patients with
small renal tumors who have elected to undergo radical nephrectomy
(removal) might provide a valuable resource for many patients with
end-stage renal failure that, to date, has been largely overlooked."