Organ Explantation Research Articles

Simultaneous Lung-abdominal Organ Procurement From Donation After Circulatory Death Donors Reduces Donor Hepatectomy Time.

Prolonged organ procurement time impairs the outcome of donation after circulatory death (DCD) and liver transplantation (LiT). Our transplant team developed a simultaneous, rather than sequential, lung-abdominal organ explantation strategy for DCD donation to prioritize liver procurement. We evaluated whether this change in strategy effectively reduced donor hepatectomy time (dHT), without affecting donor pneumonectomy time (dPT), and influenced LiT and lung transplantation outcome. All lung-abdominal and abdominal-only transplant procedures between 2010 and 2020 were analyzed in this retrospective cohort study. Relationships were assessed between the year of transplant and dHT and dPT (univariate linear regression), 1-y patient and graft survival, primary graft dysfunction, and nonanastomotic biliary strictures (univariate logistic regression). Fifty-two lung-abdominal and 110 abdominal-only DCD procedures were analyzed. A significant decrease in dHT was noted in lung-abdominal (slope -1.14 [-2.14; -0.15], P = 0.026) but not in abdominal-only procedures; dPT did not increase. There were no significant associations between the year of transplant and nonanastomotic biliary strictures frequency, primary graft dysfunction incidence, 1-y patient, and graft survival. Simultaneous organ procurement in multiorgan lung-abdominal DCD procedures is feasible, and effectively shortened dHT without affecting lung transplantation outcome. No impact on LiT outcome was observed; however, larger multicenter studies are needed.

From out of hospital resuscitation to organ explantation: a case report

From out of hospital resuscitation to organ explantation: a case report

The Future Is Now: OrganEx Technology and Its Implications for Transplant Medicine.

The Future Is Now: OrganEx Technology and Its Implications for Transplant Medicine.

Procedures of brain death diagnosis and organ explantation in a tertiary medical centre - a retrospective eight-year cohort study.

To assess the frequency and variables associated with the need for ancillary tests to confirm suspected brain death in adult patients, and to assess the time from brain death to organ explantation in donors. We further sought to identify modifiable factors influencing the time between brain death and start of surgery. Medical records and the Swiss organ allocation system registry were screened for all consecutive adult patients diagnosed with brain death at an intensive care unit of a Swiss tertiary medical centre from 2013 to 2020. The frequency and variables associated with the performance of ancillary tests (i.e., transcranial doppler, digital subtraction angiography, and computed tomography angiography) to confirm brain death were primary outcomes; the time from death to organ explantation as well as modifying factors were defined as secondary outcomes. Among 91 patients with a diagnosis of brain death, 15 were not explanted and did not undergo further ancillary tests. Of the remaining 76 patients, who became organ donors after brain death, ancillary tests were performed in 24%, most frequently in patients with hypoxic-ischaemic encephalopathy. The leading presumed causes of death (not mutually exclusive) were haemorrhagic strokes (49%), hypoxic-ischaemic encephalopathies (33%) and severe traumatic brain injuries (22%). Surgery for organ explantation was started within a median of 16 hours (interquartile range [IQR] 13-18) after death with delay increasing over time (nonparametric test for trend p = 0.05), mainly due to organ allocation procedures. Patients with brain death confirmed during night shifts were explanted earlier (during night shifts 14.3 hours, IQR 11.8-16.8 vs 16.3 hours, IQR 13.5-18.5 during day shifts; p = 0.05). Ancillary tests to confirm brain death are frequently performed, mainly in resuscitated patients. The delay to surgery for organ explantation after confirmed brain death was longer during day shifts, increased over time and was mainly determined by organ allocation procedures.

Simultaneous right-sided nephrectomy with orthotopic liver and kidney transplantation\u2014An alternative method for patients with autosomal dominant polycystic liver and kidney disease

PurposeIn patients suffering from autosomal dominant polycystic liver and kidney disease (ADPLKD), combined organ transplantation often poses a technical challenge due to the large volume of both organs. To simplify the transplantation procedure by improving the exposure of anatomical structures, we introduce a novel surgical technique of orthotopic liver and kidney transplantation.MethodsThe modified simultaneous liver and kidney transplantation technique via a right-sided L-incision included three steps: (1) right-sided nephrectomy in the recipient followed by (2) orthotopic liver transplantation in cava replacement technique and (3) the orthotopic kidney transplantation with arterial reconstruction to the right common iliac artery.ResultsIn total, seven patients with ADPLKD were transplanted by using the modified transplantation technique. The mean operation time was 342.43 min (±68.77). Postoperative patients were treated for 6.28 days (±2.50) in the intensive care unit and were discharged from the surgical ward approximately 28 days (±5.66) after the operation with normal graft function. Complications associated with the use of the modified technique, such as bleeding, anastomotic stenosis, biloma, or urinoma, did not occur.ConclusionModified simultaneous liver and kidney transplantation is a safe alternative for patients with ADPLKD. By combining right-sided nephrectomy and orthotopic graft transplantation, the approach optimizes the exposure of anatomical structures and simplifies the transplantation procedure. Additionally, the modified transplantation technique does not require a particular organ explantation procedure and can be applied for all liver and kidney grafts.

Organ Donor Cards in Resuscitation Room Patients.

The percentage of organ donors among the German population is very low, and the supply of organs does not meet the demand. Relatively few organ explantations are performed in Germany, compared to other countries. The central element leading up to organ explantation is the donor's consent. This can be expressed either orally or in writing, in the form of an advance directive or organ donor card. The goal of this study was to find out how many patients in hospital resuscitation rooms had organ donor cards on their person. The study population encompassed all 2044 patients treated in the trauma surgery resuscitation room at the Essen University Hospital from 1 February 2017 to 31 March 2019. The data were retrieved from protocols of patient possessions made on admission. The measures taken to enhance data quality were sensitization of the documenting nursing staff and documentation by the first author himself. The literature led us to expect a card-carrier rate of 36%. Over the entire period of the study, 17 organ donor cards were found (0.8%; 95% confidence interval, [0.5; 1.3]). The figures in all patient subgroups were markedly below the expected 36%. The low rate of carrying organ donor cards could not be explained by a poor quality of documentation. The organ donor card system as it currently exists in Germany is inadequate. These cards are not carried in the emergency situations for which they were developed.

Surgical Aspects of Split Liver Transplantation

Introduction Split liver transplantation is the important component of developed liver transplant program, which allows to increase the effectiveness of deceased donation. Nevertheless, at the present time there is absence of common concept of donor selection for liver transsection into two viable fragments. The “classical split” in left lateral section (LLS) and extended right lobe (ERL) is most preperable type of this procedure. The surgical issues of graft splitting discussed are “ in situ/ex situ” division . Purpose to analyze the surgical aspects of obtaining two grafts from the split liver from deceased donors in single center. Materials and methods Since June 2008 to October 2017, 16 cases of split liver transplantation were performed. 12 SLT of them were performed in 2016 and 2017. That allowed to make transplantations of liver fragments in 34 recipients. The age of deceased donors was between 18 and 54 years (25 ± 5 years). In eleven cases, parenchyma transsection was performed completely in situ. During in situ splitting the conversion to ex situ was performed due to the hemodynamic instability of the donor in 3 cases. When parenchyma transsection was finished on the back bench after organ explantation and flashing (ex situ). The liver graft was divided into the LLS and ERL completely ex situ on the back bench (I, IV-VII segments) in 3 cases. The age of LLS recipients ranged from 6 months to 6 years (mean 22 months), weight - from 5 to 16 kg (mean 9,4 ± 3,9 kg). The age of ERL recipients was from 8 to 54 years (mean 17 years), and weight was from 21 to 65 kg (mean 39 ± 11,9 kg). Results The protocol of the deceased donor selection for split liver transplantation was proposed. Small-for-size syndrome wasn’t observed in this series. The follow up without complications was observed in 20 of 32 recipient. 1-, 3-, 5- y graft and recipient survival was 85.3%, 85.3% and 79.4% respectively. Conclusion Split liver transplantation is an effective method viable recipients with terminal stage liver disease. Division of liver in LLS and ERL allows to obtain two quality grafts for transplantation and to prevent small-for size syndrome in recipient. In situ/ex situ splitting doesn’t influence on result.

Determination of Death in Execution by Lethal Injection in China

Since 1997, execution in China has been increasingly performed by lethal injection. The current criteria for determination of death for execution by lethal injection (cessation of heartbeat, cessation of respiration, and dilated pupils) neither conform to current medical science nor to any standard of medical ethics. In practice, death is pronounced in China within tens of seconds after starting the lethal injection. At this stage, however, neither the common criteria for cardiopulmonary death (irreversible cessation of heartbeat and breathing) nor that of brain death (irreversible cessation of brain functions) have been met. To declare a still-living person dead is incompatible with human dignity, regardless of the processes following death pronouncement. This ethical concern is further aggravated if organs are procured from the prisoners. Analysis of postmortem blood thiopental level data from the United States indicates that thiopental, as used, may not provide sufficient surgical anesthesia. The dose of thiopental used in China is kept secret. It cannot be excluded that some of the organ explantation surgeries on prisoners subjected to lethal injection are performed under insufficient anesthesia in China. In such cases, the inmate may potentially experience asphyxiation and pain. Yet this can be easily overlooked by the medical professionals performing the explantation surgery because pancuronium prevents muscle responses to pain, resulting in an extremely inhumane situation. We call for an immediate revision of the death determination criteria in execution by lethal injection in China. Biological death must be ensured before death pronouncement, regardless of whether organ procurement is involved or not.

Preconditioning by cilostazol protects against cold hepatic ischemia-reperfusion injury.

In liver transplantation, prolonged cold storage and post-transplant reperfusion are associated with endothelial inflammation, organ dysfunction, and graft failure. We herein studied whether cilostazol, a phosphodiesterase-3-inhibitor, attenuates post-ischemic liver injury after prolonged cold storage. Sprague-Dawley rats were assigned to 5 groups (n=6 each): sham animals (cold storage time (CST): 1 h), vehicle-treated (NaCl 0.9%) controls (CST: 24 h), and animals receiving 0.1, 1.0, or 10.0 mg/kg body weight (BW) cilostazol pre-treatment (CST: 24 h). After organ explantation, all livers were stored at 4°C in HTK solution, followed by 60 min of reperfusion with 37°C Krebs Henseleit buffer in a non-recirculating ex situ system. Bile flow was measured to evaluate liver function. To analyze inflammation and morphology, liver tissue samples were taken and histology, immunohistochemistry, and Western blotting were conducted. In vehicle-treated controls, prolonged cold storage and warm reperfusion induced inflammation, organ dysfunction, and cell death. This was indicated by an increase of hepatocellular vacuolization, endothelial ICAM-1 expression, and apoptotic cell death compared to sham animals. Cilostazol pre-treatment protected against cold hepatic ischemia-reperfusion injury by preventing hepatocellular disintegration, ICAM-1-associated endothelial inflammation, and apoptotic death. Inhibition of PDE3 reduces endothelial cell activation and hepatocellular injury in cold ischemia/reperfusion of the liver.

Delayed Renal Graft Function in the Early Post-Transplant Period and its Impact on the Late Post-Transplant Results

Delayed renal graft function (DGF) is a frequent complication with negative impact on the course of early post-transplantation period. The data concerning the impact on the late results are contradictory. This study describes results of 5-year follow-up of 248 recipients after deceased donor renal transplantation. All patients were divided into two groups: with delayed graft function (DGF, n = 53) and immediate graft function, considered as the control group (IGF, n = 195). We evaluated factors that were associated with development of DGF and its impact on the survival of graft and recipient, and frequency of acute rejections and chronic dysfunctions. The rate of observed DGF was 21.4%. Its development was associated with the following factors: age of recipient and their weight, age of donor and their body mass index, high frequency of asystole/hypotension in donors prior to organ explantation (P < 0.05 for all), and longer time of cold ischemia (P = 0.058). The DGF group had higher rate of acute rejections (P < 0.001), and also lower 1.5 and 5-year graft survival and 1.5-year patient survival (P < 0.05 for all). The conclusion is that DGF has negative impact on the survival of renal grafts and patients, especially during the first 1.5 years after transplantation.

Der Diskurs über die rechtliche Regelung der Organtransplantation in West- und Ostdeutschland (1960–1989). Eine vergleichende Studie

The debate on the legal frameworks of organ transplantation in Germany began in the 1960s with the upcoming of new medical treatments. Since there were two German States at that time, the Federal Republic of Germany (FRG) and the German Democratic Republic (GDR), the process of the discussion on the way to legislation took place under two very different circumstances. In 1975 the GDR implemented a decree regarding the legal aspects of organ transplantation. Meanwhile the discussion in the FRG proceeded with no result until 1997. The analysis of articles in German medical and juridical journals in the period 1960-1989 showed that the discussion in the GDR was less intensive than in the FRG and nearly stopped after the decree from 1975. The majority of the East-German authors preferred an arrangement that will keep the next of kin of a deceased person out of the process of organ transplantation. They argued for the so-called “Widerspruchslosung” (dissent solution): During his lifetime, the donor must have denied organ removal after his death; otherwise organ explantation will be performed. The law of 1975 was consistent with this preference. In West-Germany the motifs concerning the legal aspects of organ transplantation changed over the time. The discussion started with the same arguments that were used in East-Germany. The physicians wished some kind of “Widerspruchslosung” manifested by a draft law, but their requests changed over time. In the early 1980s, most of the West-German authors pleaded for what had become the code of practice because no bill was passed by the politicians: the “Zustimmungslosung” (consent solution). The physician was obliged to ask the next of kin if there was any statement of the potential donor towards organ donation. Some authors even considered a bill unnecessary, as the system organ transplantation in West-Germany was working well without it. A massive change in the West-German medical society from fighting for a “Widerspruchslosung” to acceptance of a “Zustimmungslosung” or even no legal frame at all was observed.

Bile Duct Damage after Cold Storage of Deceased Donor Livers Predicts Biliary Complications after Liver Transplantation

Introduction: Though biliary complications remain a major cause of morbidity after liver transplantation, no study has investigated biliary epithelial damage between organ retrieval and transplantation. The aim of this study was to examine the development of biliary damage and its clinical relevance for the patients. Methods: Common bile duct samples at organ explantation, after cold storage, and after reperfusion were compared to healthy controls by H&E staining, immunohistochemistry for Ki-67 and immunofluorescence for tight junction protein 1 (TJP1) and Claudin-1 (Cl-1). A bile duct damage score to quantify biliary epithelial injury was developed and correlated with recipient and donor data and patient outcome. Results: Control (N=16) and explantation bile ducts (N=10) showed regular epithelial morphology and tight junction architecture. After cold storage (N=19; P=.0070) and even more after reperfusion (N=51; P=.0002), epithelial damage, as quantified by a bile duct damage score, was markedly increased, and both TJP1 and Cl-1 were detected with inappropriate morphology. Proliferation rates of epithelial cells were significantly reduced after cold storage (12±3%) and reperfusion (4±1%) compared to control (20±3%) or explantation specimens (24±6%). Patients with major bile duct damage after cold storage (Sample B) and also after reperfusion (Sample C) had a significantly increased risk of biliary complications (relative risk 10.3; P=.0017 and relative risk 2.8; P=.0078) (Fig. 1) and graft loss (P=.0177 and P=.0191) (Fig. 2).[Fig. 1][Fig. 2]Conclusion: In many cases, the common bile duct epithelium shows considerable damage after cold ischemia with further damage occurring after reperfusion. The extent of epithelial damage can be quantified by our newly developed bile duct damage score and is a prognostic parameter for biliary complications and graft loss.

Ergebnisse einer internetbasierten Umfrage zur Hornhautspendebereitschaft bei DOG-Mitgliedern

Analysis of willingness for postmortem cornea donation by professionals in ophthalmology and their motives in favor of or against donation. 3887 members of the German Ophthalmological Society received an anonymous questionnaire concerning sociodemographic background, physical health, experiences with organ explantation and their former engagement and motives concerning organ and cornea donation. 722 of the questionnaires were partially and 533 completely answered with an average willingness for cornea donation of 79.4%. Significant parameters for cornea donation were gender, former experience with organ explantation, ophthalmological health and fear of false diagnosis of brain death, worse medical treatment or organ commercialization. Of the participants 53.9% suggested the internet as a favorite source of information in this matter. The factors which had a significant impact on cornea donation in this survey seem to be mainly a result of insufficient information. Detailed information regarding this topic should preferentially be presented on internet pages of professional societies and could probably increase donation approval of DOG members.

Management von Organspendern und Organempfängern - Hirntoddiagnostik

Despite of some discussion, there is general acceptance of the brain death criterion. As for Germany, there is a quasi legal regulation (TPG §16): two physicians with a longstanding experience in the management of patients with severe brain lesions are personally responsive for the diagnostic procedure lege artis. No false positive diagnosis has been published, hitherto. Before any organ explantation, diagnosis of brain death is mandatory. Nevertheless, discussions on brain death should not be instrumentalized by circumstances of organ explantation. Brain death should be part of a good educational background, to anticipate reflections free from the emotional binding of an acute incident.

Altered Cytoskeletal Structure of Smooth Muscle Cells in Ureteropelvic Junction Obstruction

Ureteropelvic junction obstruction is one of the most common causes of hydronephrosis in children. A malfunction of smooth muscle cells is believed to be the underlying mechanism causing obstruction. We investigated the expression of some integrins, talin and β-dystroglycan, considered the main compound of smooth muscle cell cytoskeleton, and active caspase 3 at the level of the ureteropelvic junction obstruction. Specimens were obtained at pyeloplasty in 12 children with ureteropelvic junction obstruction. Six control specimens were obtained during organ explantation. Specimens were divided into renal pelvis, ureteropelvic junction and ureter below the obstruction. Western blot analysis of active caspase 3, and immunofluorescence and polymerase chain reaction analysis were performed for α7A, β1A, α7B and β1D integrins, talin and β-dystroglycan. Talin and β-dystroglycan were slightly impaired in ureteropelvic junction obstruction, while α7B and β1D integrins were severely reduced, and α7A, β1A and active caspase 3 were significantly enhanced compared to controls. We demonstrated activation of apoptosis and a critical alteration of cytoskeleton that might explain the altered function and the increased apoptosis in smooth muscle cells in ureteropelvic junction obstruction. The delayed rearrangement of the cytoskeleton of smooth muscle cells in ureteropelvic junction obstruction might be linked to a postnatal splicing from α7A and β1A to α7B and β1D integrins, respectively. This relationship could explain the common clinical scenario of spontaneous improvement of hydronephrosis in children with suspected ureteropelvic junction obstruction.

Cold storage and ischemia-reperfusion injury during liver transplantation influences epithelial architecture of the bile duct

Introduction: Biliary complications remain a major cause of graft failure after liver transplantation. In part, these problems result from ischemia-reperfusion injury. Between biliary epithelial cells tight junction proteins play an essential role for permeability and barrier function. Our aim was to examine the influence of cold storage and ischemia-reperfusion in liver transplantation on biliary epithelial cell architecture. Material and Methods: We examined common bile ducts from liver grafts immediately after organ explantation, and following reperfusion of the transplanted liver. Healthy bile ducts served as controls. Tissue specimens were examined by H&E staining and fluorescence immunohistochemistry for Tight junction protein 1 (TJP1), Claudin 1 (Cl1) and the proliferation marker Ki67. Results: ontrol sections showed intact morphology of the epithelium with consistent localization of TJP1 and Cl1 at the apical end of the biliary epithelial cells. Further, low expression of Ki67 could be detected (13.3%+-2.8% of cells), indicating proliferation of the biliary epithelium. In addition, sections obtained immediately after organ explantation displayed regular morphology and high proliferative activity of the biliary epithelium measured by Ki67 immunohistochemistry. In contrast, the epithelial architecture of the bile duct following reperfusion was partially destroyed. TJP1 and Cl1 could not be detected with an appropriate morphologic pattern and virtually no proliferating biliary epithelial cells were present (1%+-0.58% of cells, p=0.132). Conclusion: Cold storage and ischemia-reperfusion injury during liver transplantation causes damage to the biliary epithelium and destruction of tight junction morphology leads to reduced barrier function of the epithelium. In addition, the absence of Ki67 following reperfusion suggests that the regenerative function of epithelial cells is impaired. This may represent a reason for biliary complications following liver transplantation.

Integrins expression of smooth muscle cells in ureteropelvic junction obstruction

The ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. An altered intrinsic malfunction of smooth muscle cells (SMC) is believed to be the underlying mechanism of obstruction. The cytoskeletal structure in SMC in the pathophysiology of UPJO are not intestigated. We have valued the expression of some integrins, talin and β-dystroglycan, that are considered main compound of SMC cytoskeleton. 12 human specimens were obtained during pyeloplasty from children while 6 control specimens were collected during organ explantation. Resected specimens were divided in pelvis, ureteropelvic junction and ureter below the obstruction. An immunofluorescence and a PCR analysis were performed for α7A-, β1A-, α7Band β1D-integrin, talin and β-dystroglycan. Control reactions showed a strong staining of α7Band β1Dintegrin, talin and β-dystroglycan while a weak positivity of α7Aand β1A-integrin was recorded. Differently, in obstructed UPJ talin and β-dystroglycan were slightly impaired, α7Band β1D-integrin were severely reduced and α7Aand β1A-integrin were significantly enhanced. Our observations showed a critical alteration of cytoskeleton and these might justify the altered function and the increased apoptosis in SMC of UPJO. A delayed rearrangement of the cytoscheleton of SMC in UPJO might be linked to a postnatal splicing from α7A and β1A to, respectively, α7Band β1D-integrins. These data perfectly are in accordance with the clinical evidence of a possible post-natal healing of congenital intrinsic UPJO.

Preemptive therapy is not adequate for prevention of cytomegalovirus disease in pancreas–kidney transplant recipients

Cytomegalovirus (CMV) remains the most common viral infection after pancreas-kidney transplantation (PKT). Comparative studies about CMV prophylaxis in PKT have not been developed. We analyzed CMV disease in a cohort of 84 PKT recipients. All received intravenous ganciclovir during treatment with anti-thymocyte globulin and later one of the following options for pre-transplant CMV-seropositive recipients: (a) no prophylaxis (n=10 patients), (b) preemptive therapy (PT) (n=13), or (c) continuous prophylaxis (CP) for 12 weeks (n=29). Pre-transplant CMV-seronegative recipients received CP (n=21). Eleven patients were excluded because of organ explantation in the first 15 days. Incidence of CMV disease in seropositive recipients was 30% under no prophylaxis, 23% under PT, and 6.9% under CP. Incidence of CMV disease under CP was 33.3% in seronegative recipients. Six of 9 episodes of CMV disease under CP occurred after finishing prophylaxis. Under CP, the incidence of CMV disease was significantly higher in seronegative than in seropositive recipients (P<0.05). According to the results of our study, for CMV-seropositive PKT recipients, CP is a better strategy than PT. For CMV-seronegative recipients, 3 months of CP is an inadequate strategy.

Sarcoglycan Subcomplex Expression in Refluxing Ureteral Endings

Functional and structural lesions of ureteral endings seem to alter the active valve mechanism of the ureterovesical junction, causing vesicoureteral reflux. The interaction of the dystroglycan complex with components of the extracellular matrix may have an important role in force transmission and sarcolemma protection, and the sarcoglycan complex is an essential component of the muscle membrane located dystroglycan complex. We performed immunofluorescence and molecular analysis on the expression of sarcoglycan complex subunits. A total of 21 specimens of refluxing ureteral endings were obtained during ureteral reimplantation. Six ureteral ends obtained during organ explantation were used as controls. Immunohistochemical analysis and reverse transcriptase polymerase chain reaction evaluation were performed for alpha, beta, gamma, delta and epsilon-sarcoglycan complex. The Spearman test revealed a significant positive correlation between alpha-sarcoglycan complex immunofluorescence intensity and grade of vesicoureteral reflux, while a negative correlation was recorded between epsilon-sarcoglycan complex immunofluorescence intensity and grade of vesicoureteral reflux. Semiquantitative analysis demonstrated a significant grade related impairment of epsilon-sarcoglycan complex coupled with an increased expression of alpha-sarcoglycan complex. This observation suggests that the structural deficiency of the trigonal ureterovesical junction could cause a passive stretching of refluxing urine on the ureter, deranging the multimodular tensegrity architecture of the sarcoglycan subcomplex, or that the sarcoglycan complex could have a key role in the physiopathology of vesicoureteral reflux. In fact, the defect in any of the sarcoglycan complexes results in degeneration of membrane integrity and muscle fiber. An altered configuration of the sarcoglycan complex could explain the structural and functional changes in refluxing ureteral endings. Our observations underline the assumption that primary vesicoureteral reflux might be regarded as a sarcoglycanopathy with marked quantitative deficiency of epsilon-sarcoglycan complex and over expression of alpha-sarcoglycan complex.

Lipomatosis renal en donante cadáver

ObjectivesThe aim of this clinical note is to report one case of incidental superficial renal mass during an organ explantation. MethodsThe renal donor was a 56-years-old male patient death for subaracnoidea haemorrhage without urological history. ResultsThe anatomopathologic intraoperative study of the renal masses informed about the fatty nature of the tissue, and the renal implantation was performed. Conclusions: The find of a superficial renal mass during an organ explantatiation determine the necessity of a preoperative biopsy.