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Modification of the nephrometric scale for assessing the complexity of a transplanted kidney resection DOI: 10.29188/2222-8543-2025-18-3-38-48
- Trushkin R.N. – Dr. Sci., professor of the Department of Urology and Operative Nephrology with a course of oncourology at RUDN University, Head of the Department of Urology of the Moscow Clinical Scientific Research Center Hospital 52 of the Moscow Department of Health; Moscow, Russia; RSCI Author ID 454825,https://orcid.org/0000-0002-3108-0539
- Medvedev P.E. – PhD, urologist of the urological department of the Moscow Clinical Scientific Research Center Hospital 52 of the Moscow Department of Health; Moscow, Russia; RSCI Author ID 1231360,https://orcid.org/0000-0003-4250-0815
- Sokolov A.A. – PhD, urologist at the Central Clinical Hospital with a Polyclinic of the Presidential Property Management Departmen, Moscow, Russia; RSCI Author ID 889052
- Sokolov S.A. – urologist of Moscow Clinical Scientific Research Center Hospital 52 of the Moscow Department of Health, Moscow, Russia; RSCI Author ID 1273635
- Polyakov N.V. – PhD, Head of the Reconstructive Urology Group of the Department of General and Reconstructive Urοlοgy of N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology – branch of the National Medical Research Radiological Center of the Ministry of Health of Russian Federation; Moscow, Russia; RSCI Author ID 412267
- Apolikhin O.I. – Dr. Sci., professor, сor.-member of RAS, director of N. Lopatkin Scientific Research Institute of urology and Interventional Radiology – branch of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation; Moscow, Russia; RSCI Author ID 683661, https://orcid.org/0000-0003-0206-043X
- Kaprin A.D. – Dr. Sci., professor, academician of RAS, general director of the National Medical Research Centre of Radiology of Ministry of health of Russian Federation, director of P.A. Herzen Institution, Head of Department of Oncology and Radiology named after V.P. Kharchenko of RUDN University; Moscow, Russia; RSCI Author ID 96775, https://orcid.org/0000-0001-8784-8415
107 Introduction. Kidney transplantation is the most effective method of treating patients with end-stage chronic renal failure. Recipients of donor kidneys have a significantly increased risk of developing renal cell carcinoma of the graft, while its surgical treatment is very difficult due to the pronounced differences in the anatomy of the transplant from native kidneys. Currently, there is no nephrometric scoring system for assessing the complexity of resection and the risk of complications adapted to the transplanted kidney, which was the reason for the development of a nephrometric scale modified for the kidney transplant.
Materials and methods. A search of publications was performed in the PubMed, Cyberlennika, eLibrary databases using the keywords: «transplanted kidney», «resection», «renal cell carcinoma», «nephrometric scale». 59 publications were selected and included in this review. The clinical material is based on the analysis of the experience of the urology department of City Clinical Hospital No. 52, where 31 patients with renal cell carcinoma of the transplanted kidney were examined and operated on.
Results. An overview of existing nephrometric scales is given, the R.E.N.A.L. and PADUA (Preoperative Aspects and Dimensions Used for an Anatomical classification of renal tumors) scales are described in detail, the features of surgical treatment of renal cell carcinoma of the transplanted kidney and the developed modified R.E.N.A.L.-TK scale are presented. A clinical case of successful laparoscopic resection of the transplanted kidney with a preliminary assessment of the complexity of the operation using the modified R.E.N.A.L.-TK scale is presented.
Conclusions. Organ-preserving surgical treatment of cancer of the transplanted kidney has its own pronounced distinctive features compared to the corresponding treatment of the native kidney, which makes it a more complex operation with a different characteristic spectrum of intraand postoperative complications. The use of nephrometric scales adapted to the specifics of resection of the transplanted kidney can increase the effectiveness of their use and will contribute to improving treatment outcomes.
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