Renal masses in deceased donor kidneys;
Potential to expand the donor pool through improved organ utilisation
BAUS ePoster online library. Kotecha P. 06/25/19; 259575; P8-10
Pinky Kotecha
Pinky Kotecha
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Abstract
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INTRODUCTION

Highlighting underutilisation of organs for transplant is crucial in preventing death on waiting lists. Small renal masses ≤4cm have very low metastatic potential and 20% are benign. We aim to report incidence of renal masses in potential donors, along with utilisation of affected and unaffected paired kidneys for transplantation.

METHODS

Retrospective 10-year national data (2008 – 2018), provided by NHS Blood & Transplant, was searched using key-words 'mass, tumour or cancer' in deceased donor solid organ offers. For additional donor information, the electronic offering system (EOS) was consulted. Those inappropriately coded or with insufficient data were excluded. We categorised renal mass size into small (≤4cm), medium (5-7cm), large (≥8cm).

RESULTS

12,121 deceased donor offers took place during the study period. The key-word search extracted 3233 matches in 1019 solid organ deceased donor offers. 276 potential donor offers had a kidney mass identified (64, bilateral kidney masses; 212 unilateral). This equates to 340 kidneys with a mass. Figure1.

340 kidneys with a mass offered for transplantation, 147 (43%) were transplanted. (Size range: 0.1 -10cm.) No kidney with a large solid mass was transplanted. Of the 212 contralateral unaffected kidneys from donors with a unilateral mass, 132 (62.3%) were transplanted. Table1.

Discussion
A large proportion of donor kidneys with masses were discarded. The recording of lesions at retrieval is insufficient to help retrospective analysis, with potential organ underutilisation. We await further data on oncological and functional outcomes and look to enable a national pathway to optimise appropriate organ allocation for transplantation.
INTRODUCTION

Highlighting underutilisation of organs for transplant is crucial in preventing death on waiting lists. Small renal masses ≤4cm have very low metastatic potential and 20% are benign. We aim to report incidence of renal masses in potential donors, along with utilisation of affected and unaffected paired kidneys for transplantation.

METHODS

Retrospective 10-year national data (2008 – 2018), provided by NHS Blood & Transplant, was searched using key-words 'mass, tumour or cancer' in deceased donor solid organ offers. For additional donor information, the electronic offering system (EOS) was consulted. Those inappropriately coded or with insufficient data were excluded. We categorised renal mass size into small (≤4cm), medium (5-7cm), large (≥8cm).

RESULTS

12,121 deceased donor offers took place during the study period. The key-word search extracted 3233 matches in 1019 solid organ deceased donor offers. 276 potential donor offers had a kidney mass identified (64, bilateral kidney masses; 212 unilateral). This equates to 340 kidneys with a mass. Figure1.

340 kidneys with a mass offered for transplantation, 147 (43%) were transplanted. (Size range: 0.1 -10cm.) No kidney with a large solid mass was transplanted. Of the 212 contralateral unaffected kidneys from donors with a unilateral mass, 132 (62.3%) were transplanted. Table1.

Discussion
A large proportion of donor kidneys with masses were discarded. The recording of lesions at retrieval is insufficient to help retrospective analysis, with potential organ underutilisation. We await further data on oncological and functional outcomes and look to enable a national pathway to optimise appropriate organ allocation for transplantation.

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