Surgeons who successfully performed kidney transplants after removing small cancerous and benign masses from the donated organs, have published their results in the December issue of the urology journal BJUI.
The technique, carried out by US surgeons at the University of Maryland School of Medicine in Baltimore, could offer a vital lifeline to patients with end-stage renal disease as well as increasing the supply of viable organs.
"Transplanting a living donor kidney which has been affected by a renal mass is controversial and considered a high risk" says co-author Dr Michael W Phelan. "However the ongoing shortage of organs from deceased donors, and the high risk of dying while waiting for a transplant, prompted five donors and recipients to push ahead with surgery after the small masses were found in the donor kidneys."
The five renal masses, which were discovered during routine donor evaluation, ranged from 1.0cm to 2.3cm in size. Cancerous cells were found in three of the five masses and the other two were benign.
The kidneys were removed from the donors, put on ice and taken to the recipients' operating rooms. Surgeons carefully removed the renal mass and a portion of the tissue near the mass was rushed through to pathology for confirmation that the tumour had been completed removed. The kidneys were then reconstructed and transplanted into the recipients.
One patient developed acute humoral rejection after surgery and was treated appropriately. There were no long-term problems in the transplanted kidneys and four of the patients were alive at the last follow-up, which ranged from nine to 41 months. The fifth died from an unrelated accident about a year after the transplant. None of the donors or recipients showed any evidence of recurring tumours.
The patients in the study ranged from 47 to 61 years of age, with an average age of 54, and the donors ranged from 38 to 72, with an average age of 38. Tw
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