Conservative Treatment Of Renal Cell Carcinoma In Kidney Transplantation

Purpose: To evaluate the new treatment strategies in renal cell carcinoma (RCC) that affects the graft in renal recipients.Acquisition of evidence: A literature review is made, analyzing all the published cases of conservative surgery in renal graft RCC.Synthesis of evidence: A total of 51 partial nephrectomies in renal graft patients have been described, with a graft survival rate of 88% and a recurrence rate of 6%. Most of the patients (75%) were asymptomatic at the time of diagnosis, and the mean lesion size was 2.8 cm. Enucleation was the most frequent technique employed. 77% of all immunosuppressor regimens included cyclosporine A. Six patients with graft RCC were subjected to radiofrequency ablation and two patients underwent percutaneous cryoablation, with a single case of relapse and a graft survival rate of 100%.Conclusions: Nephron-sparing surgery is a good management option in renal graft RCC, affording good oncological control and graft survival. Modification of immunosuppression with the withdrawal of cyclosporine A and the introduction of mTOR inhibitors is an adequate measure in such patients. (C) 2012 AEU. Published by Elsevier Espana, S.L. All rights reserved.