أوارم الكلية المكتشفة بمحض الصدفة أثناء استئصال الكلية من المتبرع الحي

Abstract EN

Objective: Renal tumours are considered relative contraindications for kidney donation.

Severe shortage of donation sources (living or cadaveric) leads to use the marginal organs as kidney containing tumours.

The aim of our study is to evaluate the idea of using tumour-contained kidney for donation on condition that the tumour smallsized and low-grade.

The age of recipient, his performance status and duration of preoperatively hemodialysis, all of the above mentioned are important factors in taking decision. Methods: Between January 2007 and December 2009, 288 kidney transplant operations have been done.

All of them are from living donors (relative and non-relative).

A comprehensive evaluation has been performed for living donors preoperatively (clinical examination, laboratory tests and radiologic investigations).

Radiologic investigations include, in addition to ultrasound, traditional angiogram and multislices computed tomography CT. Results: During the nephrectomy from living donors we have discovered three cases of renal tumours (1% of donors).

All of them were not diagnosed preoperatively.

Frozen section has not been performed.

We went on with nephrectomy, partial nephreatomy has been done and the specimens were sent to pathologic analysis.

We have transplanted the kidney after having the informed consent of the patient’s family.

Pathologic analysis revealed malignant tumor with negative surgical margins in the three cases.

The first patient died one week postoperatively. Graft nephrectomy has been performed for the second patient 24 hour after getting pathology.

The third patient managed by watchful waiting. Conclusions: As a result of severe shortage of kidneys available for donation and the increased number of patients suffering from end stage renal failure on the waiting list for transplantation, it may be a good option to transplant kidneys containing small-sized low-grade tumours keeping in mind that we can not rule out certainly the tumours recurrence locally or by distant metastases.