title: Contralateral nephroureterectomy for renal transplant recipients with unilateral upper urinary tract transitional cell carcinoma: a report of 12 cases.
abstract: BACKGROUND
  We sought to analyze the feasibility of prophylactic contralateral nephroureterectomy for renal transplant recipients with urothelial carcinomas.
  
  
  METHODS
  We analyzed the medical records of 12 renal transplant patients who underwent unilateral laparoscopic nephroureterectomy (first operation). Postoperative pathologic examinations confirmed that they all had urinary tract transitional cell carcinomas. At 1-3 months after the first operation, all patients underwent prophylactic contralateral nephroureterectomy (second operation).
  
  
  RESULTS
  Before the second operation, 2 patients were found to have hydronephrosis on computed tomography (CT), and postoperative pathologic examinations confirmed the lesions to be urothelial carcinomas. The other 10 patients had no detectable signs of urothelial tumors before the second operation, but postoperative pathologic examinations indicated that 3 had transitional cell carcinomas. All patients were followed for 4-70 months. Eleven patients survived; 1 died of heart attack unrelated to the procedures.
  
  
  CONCLUSIONS
  The incidence of contralateral upper urinary tract urothelial carcinoma is high in renal transplant recipients with posttransplantation urinary tract malignancies. If there are no other health risks, prophylactic contralateral nephroureterectomy should be considered.
authors.affiliation: Department of Urology, Beijing Friendship Hospital The Capital Medical University, Beijing, China.
authors.forename: H J
authors.initials: HJ
authors.lastname: Hou
authors.forename: J
authors.initials: J
authors.lastname: Xiao
authors.forename: Y
authors.initials: Y
authors.lastname: Tian
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009392:Nephrectomy; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014516:Ureteral Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*