Asian Journal of Urology (Jul 2022)

Small renal masses in kidney transplantation: Overview of clinical impact and management in donors and recipients

  • Alberto Piana,
  • Iulia Andras,
  • Pietro Diana,
  • Paolo Verri,
  • Andrea Gallioli,
  • Riccardo Campi,
  • Thomas Prudhomme,
  • Vital Hevia,
  • Romain Boissier,
  • Alberto Breda,
  • Angelo Territo

Journal volume & issue
Vol. 9, no. 3
pp. 208 – 214

Abstract

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Kidney transplantation is the best replacement treatment for the end-stage renal disease. Currently, the imbalance between the number of patients on a transplant list and the number of organs available constitutes the crucial limitation of this approach. To expand the pool of organs amenable for transplantation, kidneys coming from older patients have been employed; however, the combination of these organs in conjunction with the chronic use of immunosuppressive therapy increases the risk of incidence of graft small renal tumors. This narrative review aims to provide the state of the art on the clinical impact and management of incidentally diagnosed small renal tumors in either donors or recipients. According to the most updated evidence, the use of grafts with a small renal mass, after bench table tumor excision, may be considered a safe option for high-risk patients in hemodialysis. On the other hand, an early small renal mass finding on periodic ultrasound-evaluation in the graft should allow to perform a conservative treatment in order to preserve renal function. Finally, in case of a renal tumor in native kidney, a radical nephrectomy is usually recommended.

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