Sarcomatoid renal cell carcinoma in a renal transplant recipient.
The incidence of transplanted kidneys derived from elderly donors is increasing because of the larger waiting lists and greater age of patients with end-stage renal failure. Compared with young donors, one of the problems is the heightened risk of neoplasm transmission. We report 2 cases of kidney recipients, both of whom developed a sarcomatoid renal cell carcinoma after receiving a kidney transplant from the same 68-year-old male donor, who did not show signs of a neoplasm on a previous abdominal ultrasound or a pretransplant biopsy. The first recipient was a 66-year-old woman who developed a kidney mass with several urologic obstructive complications, tumor dissemination, and death at 9 months after kidney transplantation. The second recipient was a 48-year-old asymptomatic man with normal renal function, who was studied after the results of the first recipient, revealing another renal tumor. Transplant nephrectomy was performed and a peritoneal implant was resected. The patient is alive without evidence of a neoplasm after 18 months. Herein we have discussed the mechanisms of neoplasm transmission in kidney transplantation and possible strategies for its prevention and treatment.
Llamas
F
F
Department of Nephrology University Hospital of Albacete, Hnos Falce 37, Albacete 02006, Spain.
Gallego
E
E
Salinas
A
A
Virseda
J
J
Pérez
J
J
Ortega
A
A
Nam
S H
SH
Gómez
C
C
D000328:Adult; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000523:psychology / Q000601:surgery*; D003863:Depression / Q000150:complications; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications / Q000601:surgery; D007680:Kidney Neoplasms / Q000473:pathology* / Q000523:psychology / Q000601:surgery*; D008297:Male; D013119:Spinal Cord Injuries / Q000150:complications; D014019:Tissue Donors; D001750:Urinary Bladder, Neurogenic / Q000209:etiology; D014547:Urinary Diversion