Focal Ablative Therapy for Renal Cell Carcinoma in Transplant Allograft Kidneys

To evaluate outcomes after focal ablative therapy for renal cell carcinoma (RCC) in transplant allograft kidneys.

After institutional review board approval, patients with a history of RCC in a transplanted allograft kidney who underwent focal ablative therapy were identified. Complete chart reviews were performed and the relevant data were extracted for cumulative analysis.

Six patients were treated with focal ablative therapy for RCC in a transplanted allograft kidney at our institutional between 2010 and 2017. Masses were diagnosed at a median of 8 years (range 1 month-8 years) after transplantation. Median mass size was 3 cm. Three patients were treated with microwave ablation, 1 with percutaneous irreversible electroporation, 1 with laparoscopic cryoablation, and 1 with open cryoablation. Median follow-up was 45 months (range 8-61 months). The median creatinine level was 1.65 before ablation and 1.58 1 year after ablation. No patients required dialysis after ablation. No patients developed local recurrence during the follow-up period. However, 1 patient developed lymph node metastases 4 years after ablation. Two patients died during follow-up of other causes. At the time of death both patients had functioning grafts.

Focal ablative therapies are a feasible, renal-sparing intervention for the management of RCC in renal allografts at intermediate-term follow-up.