Purpose of review: To increase the number of patients who could benefit from renal transplantation new strategies need to be considered. The potential utility of kidneys found to contain small renal tumours has been proposed and is reviewed.
Recent findings: Successful outcomes have been observed using kidneys from deceased and live donors following excision of small incidentally detected renal cell carcinoma (RCC). In patients electing radical nephrectomy for small renal masses, the kidney, following excision of the tumour can be used as a novel form of altruistic organ donation. With these donor sources, the risk of tumour recurrence is extremely low with patient survival significantly better than the alternative of long-term dialysis and graft outcomes similar to other sources of donor organs.
Summary: Although controversial, the presence of a small renal tumour should not prevent transplantation of a kidney from either deceased or potential live donors. In circumstances, where patients elect for radical nephrectomy for small tumours, these kidneys should be considered for patients who may not otherwise have the opportunity of renal transplantation.