Kidney transplantation is the best replacement treatment for the end-stage renal disease. Currently, the imbalance between the number of patients on a transplant list and the number of organs available constitutes the crucial limitation of this approach. To expand the pool of organs amenable for transplantation, kidneys coming from older patients have been employed; however, the combination of these organs in conjunction with the chronic use of immunosuppressive therapy increases the risk of incidence of graft small renal tumors. This narrative review aims to provide the state of the art on the clinical impact and management of incidentally diagnosed small renal tumors in either donors or recipients. According to the most updated evidence, the use of grafts with a small renal mass, after bench table tumor excision, may be considered a safe option for high-risk patients in hemodialysis. On the other hand, an early small renal mass finding on periodic ultrasound-evaluation in the graft should allow to perform a conservative treatment in order to preserve renal function. Finally, in case of a renal tumor in native kidney, a radical nephrectomy is usually recommended.

Kidney transplantation (KT) is the best replacement treatment for end-stage renal disease (ESRD) and demonstrated solid advantages over hemodialysis in terms of survival and morbidity . Currently, the imbalance between the number of patients on a transplant list and the number of organs available constitutes the crucial limitation of this approach. To overcome this limitation, nowadays, most grafts come from deceased donors who are usually over 60-year-old and the most common cause of death is a cerebrovascular event. Just in a few cases, when available, a living donor’s graft is employed.

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Mishita
Jornal co-ordinator
 Journal of Clinical & Experimental Nephrology