Kidney Week

Abstract: SA-PO084

Use and Outcomes of Kidneys from Donors with Angiomyolipoma: A Systematic Review

Session Information

• Transplantation: Recipient and Donor Assessment
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 1802 Transplantation: Clinical

Authors

• Garcia Anton, Desiree, University of Mississippi Medical Center, Ridgeland, Mississippi, United States

Desiree Garcia Anton,

• Cabeza Rivera, Franco H., University of Mississippi Medical Center, Ridgeland, Mississippi, United States

Franco H. Cabeza Rivera,

• Cheungpasitporn, Wisit, University of Mississippi Medical Center, Ridgeland, Mississippi, United States

Wisit Cheungpasitporn,

Background

Renal angiomyolipoma (AML) is the most frequent mesenchymal tumor of the kidney. Although there is a rare possibility of malignant transformation of AML, this risk has not been studied in immunosuppressed patients. The safety of donors with AML and their kidney transplant recipients has not been well established.

Methods

A literature search was conducted utilizing MEDLINE, EMBASE and Cochrane Database from inception through May 15^th, 2018. We included studies that reported outcomes of kidney donors with AML or recipients of donor with AML. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42018095157).

Results

15 studies with a total of 17 donors with AML were identified. None of the donors had a diagnosis of tuberous sclerosis (TSC), pulmonary lymphangioleiomyomatosis (LAM), or epithelioid variant of AML. Donor age ranged from 35 to 77 years, and recipient age ranged from 27 to 62 years. 92% of the donors were female. Only 8% were deceased donor renal transplant. The majority of donors underwent ex-vivo resection (65%) prior to transplantation, followed by no resection (18%), and the remaining had in-vivo resection. Tumor size varied from 0.4 cm to 7 cm, and the majority (87%) were localized in the right kidney. Follow up time ranged from 1 to 107 months. Donor creatinine pre-nephrectomy ranged 0.89-1.1 mg/dL and post-nephrectomy creatinine 1.0 to 1.17 mg/dL. In those who did not have resection of the AML, tumor size remained stable. None of the donors with AML had end-stage renal disease or died at last follow-up. None of the recipients had malignant transformation of AML.

Conclusion

These findings are reassuring for the safety of donors with AML (without TSC or LAM) as well as their recipients without evidence of malignant transformation of AML. As such, this can also positively impact the donor pool by increasing the number of available kidneys.