A successful live donor kidney transplantation after large angiomyolipoma excision

Angiomyolipoma is the most common benign neoplasm of the kidney. Successful transplantation of an AML affected kidney has been reported. However it is still often seen as a contraindication to transplantation.

A 47-year-old female underwent assessment for a direct specified kidney donation to her husband who had end stage renal failure, due to adult polycystic kidney disease. Routine pre-operative CT angiography demonstrated a large 6cm×4cm AML arising from the upper pole of the right kidney. Right-side hand assisted retro-peritoneoscopic live donor nephrectomy with bench tumour excision was subsequently performed. Recipient implantation was unremarkable with no haemorrhage.

Histology confirmed a 7cm AML. At 36 months follow up, the recipient's serum creatinine was 158μmol/l and eGFR 40ml/min without the need for dialysis at any stage.

AML should not be a contraindication for specified live kidney donation, despite a size of 7cm.