Transfer of ureteral carcinoma in a transplanted kidney presenting by early stenosis of the proximal ureter.
A 71-yr-old male kidney transplant recipient suffered from delayed graft function. Eighty days after transplantation complete obstruction of the proximal ureter was observed, complicated by recurrent urinary tract infections. Two months later, the donor kidney was removed because of infectious complications and inadequate arterial perfusion. Histological examination of the removed graft showed signs of rejection as well as a low-grade papillary urothelial cell carcinoma of donor origin in the ureter. The remaining donor ureter was removed subsequently and showed no further signs of malignancy. Follow-up of the patient until 12 months after surgery did not reveal recurrence of the tumor. This case report is the first to describe accidental transfer of urothelial cell carcinoma in the ureter by transplantation, highlighting the possibility of malignancy when early stenosis is not related to the anastomosis. It again emphasizes the need for precise and cautious screening of organ donors, especially those of higher age.
Huurman
V A L
VA
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands. v.a.l.huurman@lumc.nl
Baranski
A G
AG
Groeneveld
J H M
JH
Keizer
K M
KM
Schaapherder
A F M
AF
D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology*; D003251:Constriction, Pathologic; D051799:Delayed Graft Function / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D014019:Tissue Donors; D014516:Ureteral Neoplasms / Q000473:pathology*; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery