Focal Ablative Therapy for Renal Cell Carcinoma in Transplant Allograft Kidneys

Objective: To evaluate outcomes after focal ablative therapy for renal cell carcinoma (RCC) in transplant allograft kidneys.

Methods: After institutional review board approval, patients with a history of RCC in a transplanted allograft kidney who underwent focal ablative therapy were identified. Complete chart reviews were performed and the relevant data were extracted for cumulative analysis.

Results: Six patients were treated with focal ablative therapy for RCC in a transplanted allograft kidney at our institutional between 2010 and 2017. Masses were diagnosed at a median of 8 years (range 1 month-8 years) after transplantation. Median mass size was 3 cm. Three patients were treated with microwave ablation, 1 with percutaneous irreversible electroporation, 1 with laparoscopic cryoablation, and 1 with open cryoablation. Median follow-up was 45 months (range 8-61 months). The median creatinine level was 1.65 before ablation and 1.58 1 year after ablation. No patients required dialysis after ablation. No patients developed local recurrence during the follow-up period. However, 1 patient developed lymph node metastases 4 years after ablation. Two patients died during follow-up of other causes. At the time of death both patients had functioning grafts.

Conclusion: Focal ablative therapies are a feasible, renal-sparing intervention for the management of RCC in renal allografts at intermediate-term follow-up.