Laparoscopic resection of a transplanted kidney with a large tumor


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Given the large number of patients with ESRD, kidney transplantation is currently the only effective treatment for this condition. The kidney transplant population has two-fold increased risk of developing neoplasms compared to non-transplant population. modern methods of treating transplanted kidney tumors do not differ from the methods of treating cancer of non-transplanted kidneys. The recurrence rate after organ-sparing surgery is similar to the recurrence rate in the general population. Histologically, transplanted kidney cancer is represented by both clear cell carcinoma (45.7%) and papillary renal cellcarcinima (42.1%), chromophobic kidney cancer represents 3% and other types of cancer account for 9.1% of cases. The treatment of transplanted kidney cancer includes the same methods as in the treatment of non-transpated kidney cancer: resection of the transplanted kidney, radical nephrectomy, percutaneous radiofrequency ablation of the kidney graft, and percutaneous graft cryoablation. despite the wide possibilities for the treatment of transplanted kidney cancer, there is a large percentage of patients with recurrence of both end-stage renal disease and kidney cancer, which indicates the absence of a proven treatment algorithm and provides an opportunity for a creative approach to the problem of transplanted kidney cancer. given the ambiguity of the problem of transplanted kidney cancer, we would like to represent a clinical case of treating a large, up to 100 mm, tumor of kidney graft with good oncological and functional results. despite the fact that the incidence of renal cell carcinoma in patients with a transplanted kidney is only o.19-o.5%, this clinical case is difficult for urologists.

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作者简介

Ruslan Trushkin

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: uro52@mail.ru
Dr.Sci. (Med.), Department of Urology 3 Pekhotnaya st., Moscow, 123182

Lyudmila Artyukhina

City Clinical Hospital № 52 of the Moscow Healthcare Department

Cand.Sci. (Med.), Department of Urology 3 Pekhotnaya st., Moscow, 123182

Damir Kantimerov

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: kantimeroff@gmail.com
Cand.Sci. (Med.), Department of Urology 3 Pekhotnaya st., Moscow, 123182

Teimur Isaev

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: dr.isaev@mail.ru
Cand.Sci. (Med.), Department of Urology 3 Pekhotnaya st., Moscow, 123182

Nikolay Shcheglov

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: nickshch@mail.ru
Department of Urology 3 Pekhotnaya st., Moscow, 123182

Oleg Shevtsov

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: shevcovos@yandex.ru
Department of Urology 3 Pekhotnaya st., Moscow, 123182

Tamara Klementieva

City Clinical Hospital № 52 of the Moscow Healthcare Department

Email: tamara-klementeva@mail.ru
Cand.Sci. (Med.), Department of Urology 3 Pekhotnaya st., Moscow, 123182

参考

  1. Griffith J.J., et al. Solid Renal Masses in Transplanted Allograft Kidneys: A Closer Look at the Epidemiology and Management. Am. J. Transplant. 2017;17(11):2775-81.
  2. Tillou X., et al. Renal cell carcinoma in functional renal graft: Toward ablative treatments. Transplant. Rev. (Orlando). 2016;30(1):20-6.
  3. Tillou X., et al. Nephron sparing surgery for De Novo kidney graft tumor: results from a multicenter national study. Am. J. Transplant. 2014; 14(9):2120-25.

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