You have accessJournal of UrologyTransplantation & Vascular Surgery: Renal Transplantation, Vascular Surgery II1 Apr 20122274 CLINICAL TRIAL OF RESTORED KIDNEY TRANSPLANT AFTER RESECTION OF RENAL CELL CARCINOMA: RESULTS OF THE INITIAL AND EXTENDED STUDIES Yoshihide Ogawa, Tomoharu Kobayashi, Shinyu Shiroma, Keimei Kojima, Rensuke Mannami, Makoto Mannami, Keiichi Kitajima, Mitsuo Nishi, Seiichi Ito, and Naoki Mitsuhata Yoshihide OgawaYoshihide Ogawa Akishima, Japan More articles by this author , Tomoharu KobayashiTomoharu Kobayashi Akishima, Japan More articles by this author , Shinyu ShiromaShinyu Shiroma Uwajima, Japan More articles by this author , Keimei KojimaKeimei Kojima Uwajima, Japan More articles by this author , Rensuke MannamiRensuke Mannami Uwajima, Japan More articles by this author , Makoto MannamiMakoto Mannami Uwajima, Japan More articles by this author , Keiichi KitajimaKeiichi Kitajima Kagoshima, Japan More articles by this author , Mitsuo NishiMitsuo Nishi Marugame, Japan More articles by this author , Seiichi ItoSeiichi Ito Kure, Japan More articles by this author , and Naoki MitsuhataNaoki Mitsuhata Kure, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2452AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Kidneys from patients with small renal cell carcinomas (RCC) have been considered as a potential source for solving the organ donor crisis. Buell, Mannami, and Nicol respectively reported 14, 8, and 31 transplant procedures using kidneys after resection of RCC. Nalesnik et al. recently performed the first step towards evaluating the risk of cancer transmission to optimize organ usage. However, no prospective data are available on the transmission risk for RCC. To address this issue and raise awareness, we performed a prospective open trial that utilized resected kidneys for transplant into third-party recipients after restoration. METHODS Our study of restored kidney transplant had an estimated enrollment of 5 patients with one year of follow-up and was approved by Tokushukai Joint Ethics Committee and registered with U.S. ClinicalTrials.gov. Donors were selected from among patients who opted to undergo nephrectomy for small RCC after extensive discussion of other possible treatment modalities. After nephrectomy, the tumor was removed from each resected kidney, which was restored and transplanted into an unrelated recipient who was selected by a third-party selection committee based on the blood group match, high clinical evaluation score, and negative cross-match test. The trial was extended to enroll another 5 patients after the fifth transplant because of strong requests from other patients. RESULTS In the initial study, five male patients aged 51-79 years were the kidney donors. The nephrometry RENAL scores for their renal tumors (Kutikov-Uzzo) were 6 or 7, suggestive of moderate complexity. A total of 56 dialysis patients aged 31-83 years (mean: 58.7 years) were enrolled as candidate recipients. Two recipients had a history of kidney transplant. All patients received triple immunosuppression. Four recipients have experienced rejection episodes so far and the latest serum creatinine levels range from 1.22 to 1.67 mg/dl after 15 to 23 months of follow-up. There has not been any recurrence of RCC. In the extended study, 4 patients aged 46-65 years have undergone restored kidney transplant so far and their recent creatinine levels range from 1.06 to 1.80 mg/ml without tumor recurrence. CONCLUSIONS Selected candidates can benefit from restored kidney transplant, achieving good renal function without recurrence of RCC. Urologists should bridge the growing gap between the number of donor kidneys needed and the available supply by employing discarded kidneys with small RCC for renal transplantation. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e917-e918 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yoshihide Ogawa Akishima, Japan More articles by this author Tomoharu Kobayashi Akishima, Japan More articles by this author Shinyu Shiroma Uwajima, Japan More articles by this author Keimei Kojima Uwajima, Japan More articles by this author Rensuke Mannami Uwajima, Japan More articles by this author Makoto Mannami Uwajima, Japan More articles by this author Keiichi Kitajima Kagoshima, Japan More articles by this author Mitsuo Nishi Marugame, Japan More articles by this author Seiichi Ito Kure, Japan More articles by this author Naoki Mitsuhata Kure, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...