Frequency and Predictors of Renal Transplantation Among Patients Rendered Surgically Anephric for Sporadic Renal Cancer

Timothy C. Boswell, Vidit Sharma, Mary E. Westerman, Patrick G. Dean, George K. Chow, R. Houston Thompson, Bradley Leibovich, Stephen A. Boorjian

Research output: Contribution to journalArticle

Abstract

Objective: To assess the frequency of renal transplantation in patients rendered surgically anephric during treatment of renal cancers as well as the clinicopathologic factors associated with receipt of transplantation. Methods: A retrospective review was conducted to identify patients rendered surgically anephric between 2001 and 2016 due to cancer in both renal units or cancer in an anatomically or functionally solitary kidney. Patient demographics, comorbidities, and cancer features were compared between patients who subsequently received a renal transplantation and those who did not. Time-to-event analysis was used to compare time to transplantation across varied identified parameters. Results: Among 27 patients rendered anephric, 4 (15%) received a renal transplantation over a median follow-up of 21.6 months (interquartile range 7.2, 53.3). All transplanted patients were less than 70 years of age and had cT1a renal parenchymal mass at the time of nephrectomy. No patient undergoing completion nephrectomy for upper tract urothelial carcinoma received transplantation. Patients who were evaluated by the transplant service prior to nephrectomy were more likely to eventually undergo transplantation (60% vs 5%; P <.01). On time-to-event analyses, a cT1a renal parenchymal mass (P <.01) and a pre-nephrectomy transplant evaluation (P <.01) were associated with receipt of a transplant. Conclusion: Patients rendered anephric via nephrectomy for cancer are more likely to receive renal transplantation if they are less than 70 years old, have a cT1a renal parenchymal mass, and receive transplant consultation before nephrectomy. These data may inform future patient counseling.

Original languageEnglish (US)
Pages (from-to)134-139
Number of pages6
JournalUrology
Volume126
DOIs
StatePublished - Apr 1 2019

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Kidney Neoplasms
Kidney Transplantation
Nephrectomy
Kidney
Transplantation
Transplants
Neoplasms
Comorbidity
Counseling
Referral and Consultation
Demography
Carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

Boswell, T. C., Sharma, V., Westerman, M. E., Dean, P. G., Chow, G. K., Thompson, R. H., ... Boorjian, S. A. (2019). Frequency and Predictors of Renal Transplantation Among Patients Rendered Surgically Anephric for Sporadic Renal Cancer. Urology, 126, 134-139. https://doi.org/10.1016/j.urology.2018.12.037

Frequency and Predictors of Renal Transplantation Among Patients Rendered Surgically Anephric for Sporadic Renal Cancer. / Boswell, Timothy C.; Sharma, Vidit; Westerman, Mary E.; Dean, Patrick G.; Chow, George K.; Thompson, R. Houston; Leibovich, Bradley; Boorjian, Stephen A.

In: Urology, Vol. 126, 01.04.2019, p. 134-139.

Research output: Contribution to journalArticle

Boswell, TC, Sharma, V, Westerman, ME, Dean, PG, Chow, GK, Thompson, RH, Leibovich, B & Boorjian, SA 2019, 'Frequency and Predictors of Renal Transplantation Among Patients Rendered Surgically Anephric for Sporadic Renal Cancer', Urology, vol. 126, pp. 134-139. https://doi.org/10.1016/j.urology.2018.12.037
Boswell, Timothy C. ; Sharma, Vidit ; Westerman, Mary E. ; Dean, Patrick G. ; Chow, George K. ; Thompson, R. Houston ; Leibovich, Bradley ; Boorjian, Stephen A. / Frequency and Predictors of Renal Transplantation Among Patients Rendered Surgically Anephric for Sporadic Renal Cancer. In: Urology. 2019 ; Vol. 126. pp. 134-139.
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N2 - Objective: To assess the frequency of renal transplantation in patients rendered surgically anephric during treatment of renal cancers as well as the clinicopathologic factors associated with receipt of transplantation. Methods: A retrospective review was conducted to identify patients rendered surgically anephric between 2001 and 2016 due to cancer in both renal units or cancer in an anatomically or functionally solitary kidney. Patient demographics, comorbidities, and cancer features were compared between patients who subsequently received a renal transplantation and those who did not. Time-to-event analysis was used to compare time to transplantation across varied identified parameters. Results: Among 27 patients rendered anephric, 4 (15%) received a renal transplantation over a median follow-up of 21.6 months (interquartile range 7.2, 53.3). All transplanted patients were less than 70 years of age and had cT1a renal parenchymal mass at the time of nephrectomy. No patient undergoing completion nephrectomy for upper tract urothelial carcinoma received transplantation. Patients who were evaluated by the transplant service prior to nephrectomy were more likely to eventually undergo transplantation (60% vs 5%; P <.01). On time-to-event analyses, a cT1a renal parenchymal mass (P <.01) and a pre-nephrectomy transplant evaluation (P <.01) were associated with receipt of a transplant. Conclusion: Patients rendered anephric via nephrectomy for cancer are more likely to receive renal transplantation if they are less than 70 years old, have a cT1a renal parenchymal mass, and receive transplant consultation before nephrectomy. These data may inform future patient counseling.

AB - Objective: To assess the frequency of renal transplantation in patients rendered surgically anephric during treatment of renal cancers as well as the clinicopathologic factors associated with receipt of transplantation. Methods: A retrospective review was conducted to identify patients rendered surgically anephric between 2001 and 2016 due to cancer in both renal units or cancer in an anatomically or functionally solitary kidney. Patient demographics, comorbidities, and cancer features were compared between patients who subsequently received a renal transplantation and those who did not. Time-to-event analysis was used to compare time to transplantation across varied identified parameters. Results: Among 27 patients rendered anephric, 4 (15%) received a renal transplantation over a median follow-up of 21.6 months (interquartile range 7.2, 53.3). All transplanted patients were less than 70 years of age and had cT1a renal parenchymal mass at the time of nephrectomy. No patient undergoing completion nephrectomy for upper tract urothelial carcinoma received transplantation. Patients who were evaluated by the transplant service prior to nephrectomy were more likely to eventually undergo transplantation (60% vs 5%; P <.01). On time-to-event analyses, a cT1a renal parenchymal mass (P <.01) and a pre-nephrectomy transplant evaluation (P <.01) were associated with receipt of a transplant. Conclusion: Patients rendered anephric via nephrectomy for cancer are more likely to receive renal transplantation if they are less than 70 years old, have a cT1a renal parenchymal mass, and receive transplant consultation before nephrectomy. These data may inform future patient counseling.

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