Pathological features and outcomes of incidental renal cell carcinoma in candidate solid organ donors.

We report the findings of a single Italian center in the evaluation of renal lesions in deceased donors from 2001 to 2017. In risk evaluation, we applied the current Italian guidelines, which include donors with small (< 4 cm, stage pT1a) renal carcinomas in the category of non-standard donors with a negligible risk of cancer transmission.

From the revision of our registries, 2,406 donors were considered in the Emilia Romagna region of Italy; organs were accepted from 1,321 individuals for a total of 3,406 organs.

The evaluation of donor safety required frozen section analysis for 51 donors, in which a renal suspicious lesion was detected by ultrasound. Thirty-two primary renal tumors were finally diagnosed: 26 identified by frozen sections and 6 in discarded kidneys. The 32 tumors included 13 clear cell renal cell carcinomas (RCCs), 6 papillary RCCs, 6 angiomyolipomas, 5 oncocytomas, 1 chromophobe RCC, and 1 papillary adenoma. No cases of tumor transmission were recorded in follow-up of the recipients.

Donors with small RCCs can be accepted to increase the donor pool. Collaboration in a multidisciplinary setting is fundamental to accurately evaluate donor candidate risk assessment and to improve standardized protocols for surgeons and pathologists.

Kidney research and clinical practice. 2020 Aug 28 [Epub ahead of print]

Francesca Ambrosi, Costantino Ricci, Deborah Malvi, Carlo De Cillia, Matteo Ravaioli, Michelangelo Fiorentino, Massimo Cardillo, Francesco Vasuri, Antonia D'Errico

Pathology Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy., Emilia-Romagna Transplant Reference Centre, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy., Transplant Surgery Unit, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy., Centro Nazionale Trapianti, Roma, Italy.