TO TRANSPLANT OR NOT TO TRANSPLANT: A KIDNEY WITH A GIANT CYST. CASE REPORT AND REVIEW OF THE LITERATURE

Background: Simple renal cysts are very common in the general population (about 10.5 %) and especially in older people. They are usually small and kidneys with these lesions can be used for transplantation in selected cases. However, the presence of a “giant” cyst occuping a considerable part of the organ is a challenging situation for the transplant surgeon. Material and methods: We report the case of a DBD donor kidney with a huge cyst and review of the literature. Results: On the 8th of Novemeber 2013 we were offered a DBD kidney with a giant cyst (diameter 8.5 cm) on the inferior pole. The cyst was deroofed and frozen section performed with a diagnosis of simple cyst. There was no evidence of neoplasia and/or connection with the calyces. The cyst edges were cauterized with diathermy. The kidney was allocated to a 52 year old female patient with a BMI of 24. The post-operative course was uneventful, the graft rapidly recovered its function with no need for dialysis. The recipient was discharged home on POD X with a creatinine of 1.5 mg/dl. Renal function has been good and stable for the following 9 years (last creatinine 0.8 mg/dl) and currently the patient is in very good conditions. Conclusions: Kidneys with giant cysts can be used for transplant in selected cases, increasing the transplantable kidney pool and limiting the organ shortage. Donor and recipient’s BMI must be considered in the allocation.