Advances in TransplantationKidney transplantationOutcome of Live-Donor Renal Transplants With Incidentally Diagnosed Renal Angiomyolipoma in the Donor
Section snippets
Patients and Methods
After obtaining approval from the local institutional research board (MFM/IRB no: R.18.07.245), the dedicated electronic database of live-donor renal transplant cases were retrospectively reviewed. Patients who received kidneys with incidentally diagnosed AML at preoperative evaluation, whether the tumor was excised on back-table or left in situ and transplanted, were eligible for analysis.
As a routine, all potential donors were fully evaluated by a team including a nephrologist, a urologist,
Results
The study included 6 live, related-donor renal transplants with a median age of 21 (range, 10–38) years. The donors were healthy individuals with no comorbidities with a median age of 48 (range, 45–50) years at the time of donation. The causes of ESRD were unknown in 1, glomerulonephritis in 1, hypertensive nephropathy in 1, posterior urethral valve in 1, and vesicoureteral reflux in 2 patients. Table 1 illustrates patients' demographics.
In 2 cases, where the tumor was exophytic, ex vivo
Discussion
The reported prevalence of ESRD in Egypt was 375 patients per million people with a yearly incidence of 74 patients per million people [7]. Hemodialysis is the predominant form of renal replacement therapy. This may be attributed to the shortage of available live donors and the absence of a national deceased-donor program. Consequently, this increases the economic burden on both the health care system and diseased individuals. Thus, the need to expand the base of live donation is a necessary
Conclusion
Presence of incidentally discovered renal AML should not prohibit donation. Tumor excision (if exophytic) or keeping in situ (if small endophytic) and completing the procedure of transplantation is not associated with an increased risk of long-term complications or unfavorable graft function outcome. It might expand the criteria for accepting marginal donors in an attempt to overcome the problem of organ shortage.
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