Small renal masses in kidney transplantation

Kidney transplantation is the best replacement treatment for the end-stage renal disease. Currently, the imbalance between the number of patients on a transplant list and the number of organs available constitutes the crucial limitation of this approach. To expand the pool of organs amenable for tra...

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Detalles Bibliográficos
Autores: Piana, Alberto|||0000-0001-9247-7938, Andras, Iulia|||0000-0002-8586-3491, Diana, Pietro|||0000-0002-3259-1314, Verri, Paolo|||0000-0002-3662-6828, Gallioli, Andrea|||0000-0002-3316-5691, Campi, Riccardo|||0000-0001-5237-0888, Prudhomme, Thomas|||0000-0003-3601-9339, Hevia, Vital|||0000-0001-9498-1150, Boissier, Romain, Breda, Alberto|||0000-0002-7842-9048, Territo, Angelo|||0000-0002-5162-5356
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:281822
Acceso en línea:https://ddd.uab.cat/record/281822
https://dx.doi.org/urn:doi:10.1016/j.ajur.2022.06.001
Access Level:acceso abierto
Palabra clave:Small renal mass
Renal cancer
Kidney transplantation
Nephron-sparing treatment
Descripción
Sumario:Kidney transplantation is the best replacement treatment for the end-stage renal disease. Currently, the imbalance between the number of patients on a transplant list and the number of organs available constitutes the crucial limitation of this approach. To expand the pool of organs amenable for transplantation, kidneys coming from older patients have been employed; however, the combination of these organs in conjunction with the chronic use of immunosuppressive therapy increases the risk of incidence of graft small renal tumors. This narrative review aims to provide the state of the art on the clinical impact and management of incidentally diagnosed small renal tumors in either donors or recipients. According to the most updated evidence, the use of grafts with a small renal mass, after bench table tumor excision, may be considered a safe option for high-risk patients in hemodialysis. On the other hand, an early small renal mass finding on periodic ultrasound-evaluation in the graft should allow to perform a conservative treatment in order to preserve renal function. Finally, in case of a renal tumor in native kidney, a radical nephrectomy is usually recommended.