Presentation Authors: Mireia Musquera, Alba Sierra del Rio*, Lluis Peri, David Paredes, Claudia Mercader, Meritxell Pérez, Núria Esforzado, Maria Carme Sebastià, Maria José Ribal, Nacho Revuelta, Antonio Alcaraz, Barcelona, Spain
Introduction: It is well known the scarcity of available organs causing an increasing number of patients waiting for transplantation, so the rapid expansion of the recipient pool has increased the pressure on transplantation programs. This disparity has fomented strategies to increase the donor pool. Nowadays living donors, extended criteria donor (ECD), non-heart beating donors and non standard risk donors are different strategies adopted to maintain the number of grafts, balancing the risk-benefit in each specific situation. Along these lines it is not infrequent to find incidental renal masses in the donors, in an attempt to increase the graft number those kidneys can be considered suitable grafts after bench surgery to remove the tumor._x000D_
The aim of our study is to update the results and analyze the evolution of grafts with incidental kidney tumors after bench surgery in our center.
Methods: Retrospective analysis of donors with a diagnosis of incidental small renal mass and their corresponding recipients between January 2007 and August 2018 at the Hospital Clinic. All cases underwent an ex vivo tumorectomy with a preoperatory pathologic analysis. We analysed donor and recipient characteristics, recipient functional results and oncologic results in the living donor and recipients.
Results: Seventeen donors with incidental renal mass were detected (six living and eleven deceased donors -eight of them Maastricht II-III). The donor mean age was 54,7 (SD 16) years old. A total of 20 patients received a graft in our institution from those donors. Thirteen cases received the affected kidney, and seven the contralateral one. Recipient mean age was 58,1 (SD 11) years. _x000D_
The mean tumor diameter was 12,7 mm (SD 9,5). Pathological analysis showed two benign lesions and fifteen renal cell carcinoma (eleven clear cell, two chromophobe and two papillary 1). All but one were pTa. Surgical margins were negative. Four cases presented bleeding after reperfusion. Mean follow-up was 54 months (SD 48,9); One case present immediate vein thrombosis requiring transplantectomy. None of them present delayed graft function, however during the follow-up we have identified 3 graft lost due to chronic rejection. None of the donors neither the recipients presented tumor recurrence.
Conclusions: Kidneys with small incidental tumors are a good option for kidney transplantation in selected patients after bench surgery excision with good functional and oncologic results.