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Treatment Modality for Small Renal Masses may Affect Time to Eligibility for Renal Transplant Candidates

Login to Access Video or Poster Abstract: MP30-09
Sources of Funding: None

Introduction

There is no standardized approach to the treatment of small renal masses (SRM) in renal transplant candidates. Time on dialysis is associated with worse graft survival and overall mortality. Therefore, we conducted a study to evaluate whether treatment modality of SRM impacts time to eligibility for renal transplantation.

Methods

We queried transplant centers in the United States via an online survey. The survey was designed to analyze practice patterns to treat SRM and specifically focused on treatment modality and wait time required to become eligible for renal transplantation. Surveys were sent to 212 transplant centers in the US.

Results

We received responses from 53 (25%) US Transplant Centers, representing all 11 United Network for Organ Sharing regions. _x000D_ _x000D_ The time between definitive treatment for cT1a renal cell carcinoma and renal transplantation differed by treatment type. Responders were more likely to allow immediate transplantation after radical nephrectomy (77.4%), as opposed to partial nephrectomy (58.1%) and focal ablation (45.2%). The rest of the respondents indicated that they would observe between 2-4 years before transplantation. No respondents indicated that they would wait beyond 4 years._x000D_ _x000D_ 68.3% indicated the time interval was also dependent on tumor size; 56.9% < 1cm, 45.2% < 2cm, 11.3% < 3cm, and 9.7% < 4cm for those that indicated a threshold size._x000D_ _x000D_ In univariable analysis, respondents from institutions with experience of over 100 cases per year (OR=7.69, p=.006), with greater than 2 transplant surgeons (OR=6.83, p=.005) and with over 40 years of renal transplant experience (OR=5.06, p=.028) were more likely to proceed with immediate transplantation after definitive treatment. _x000D_

Conclusions

Time to become eligible for transplant in patients with SRM was affected by treatment modality. Eligibility time was shortest for radical nephrectomy and longest for focal ablation. Tumor size and the experience of the transplant program also affected eligibility time._x000D_ _x000D_

Funding

None

Authors
Alp Tuna Beksac
David Paulucci
John Sfakianos
Susan Lerner
Jorge Pereira
Ketan Badani
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