The incidence and implications of renal cell carcinoma in cadaveric renal transplants at the time of organ recovery

Background. With the exception of primary central nervous system tumors, or gan recovery is no longer considered from donors with known malignancy. Bec ause intrathoracic and intraabdominal organs are usually recovered before t he kidneys, we examined the incidence of renal cell carcinoma in cadaveric donor kidneys at the time of organ recovery. This would establish the theor etical risk of transplanting donor organs from a patient with a known renal malignancy. Methods. In cooperation with the Louisiana Organ Procurement Agency, we rev iewed the records of all patients who were cadaveric kidney donors in the s tate of Louisiana between September 1991 and October 1997. Information was reviewed and analyzed on donor age, sex, race, past medical/surgical histor y, cause of death, and the findings at the time of organ recovery. Results. A total of 553 consecutive cadaveric donors were identified, with 1106 kidneys recovered. Of the 553 cadaveric donors, 5 (0.9%) were noted to have an incidental renal cell carcinoma. All tumors were identified in sep arate donors; that is, none of the tumors were bilateral, None of the five donors had documented symptoms; referable to their urinary tract. All tumor s were either T1 or T2 by the tumor, node, metastasis classification system , and no evidence of nodal or distant metastatic disease was present. In on e case, the contralateral kidney, heart, and liver were transplanted before the tumor was identified. In the remaining four ca,ses, all organs (renal and nonrenal) were discarded. Conclusions, Renal cell carcinoma is rarely found during renal recovery fro m a cadaveric donor. However, because the kidneys are usually recovered aft er the intrathoracic and intraabdominal organs, careful palpation of the ki dneys and exploration of any abnormalities is mandated to avoid transplanti ng any organs from a donor with a known renal malignancy.