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Updated: Jun 26, 2025
Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol
Published on: February 21, 2016
Optimizing the kidney donor pool: transplanting donor kidneys after partial nephrectomy of masses or cysts
Marina M Tabbara1,2, Juliano Riella1,2, Javier Gonzalez3
1Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, United States.
Background:
A limiting factor in expanding the kidney donor pool is donor kidneys with renal tumors or cysts. Partial nephrectomy (PN) to remove these lesions prior to transplantation may help optimize organ usage without recurrence of malignancy or increased risk of complications.
Methods:
We retrospectively analyzed all recipients of a living or deceased donor graft between February 2009 and October 2022 in which a PN was performed prior to transplant due to the presence of one or more concerning growths. Donor and recipient demographics, perioperative data, donor allograft pathology, and recipient outcomes were obtained.
Results:
Thirty-six recipients received a graft in which a PN was performed to remove suspicious masses or cysts prior to transplant. Majority of pathologies turned out to be a simple renal cyst (65%), followed by renal cell carcinoma (15%), benign multilocular cystic renal neoplasm (7.5%), angiomyolipoma (5%), benign renal tissue (5%), and papillary adenoma (2.5%). No renal malignancy recurrences were observed during the study period (median follow-up: 67.2 months). Fourteen complications occurred among 11 patients (30.6% overall) during the first 6mo post-transplant. Mean eGFR (± standard error) at 36 months post-transplant was 51.9 ± 4.2 ml/min/1.73 m2 (N = 23). Three death-censored graft losses and four deaths with a functioning graft and were observed.
Conclusion:
PN of renal grafts with suspicious looking masses or cysts is a safe option to optimize organ usage and decrease the kidney non-use rate, with no observed recurrence of malignancy or increased risk of complications.
Insights
Partial nephrectomy (PN) on donor kidneys with masses safely increases organ availability. This procedure, removing lesions before transplant, showed no cancer recurrence and acceptable complication rates.
Area of Science:
- Nephrology
- Transplantation Surgery
- Oncology
Background:
- Expanding the kidney donor pool is crucial for transplantation.
- Donor kidneys with renal tumors or cysts are often discarded.
- Partial nephrectomy (PN) can potentially utilize these organs.
Purpose of the Study:
- To evaluate the safety and efficacy of PN on donor kidneys with suspicious masses or cysts prior to transplantation.
- To assess the impact of PN on organ utilization and recipient outcomes.
Main Methods:
- Retrospective analysis of donor kidney recipients between February 2009 and October 2022.
- Included grafts where PN was performed due to concerning masses or cysts.
- Collected data on donor/recipient demographics, perioperative details, pathology, and patient outcomes.
Main Results:
- 36 recipients received grafts after PN. Most common pathologies were simple cysts (65%) and renal cell carcinoma (15%).
- No renal malignancy recurrences were observed (median follow-up 67.2 months).
- 30.6% of patients experienced complications within 6 months post-transplant; 3 death-censored graft losses and 4 deaths with functioning grafts occurred.
Conclusions:
- PN of renal grafts with suspicious masses/cysts is a safe strategy to increase kidney utilization.
- The procedure does not appear to increase the risk of complications or malignancy recurrence.
- PN can help decrease kidney non-use rates, optimizing the donor pool.
