RENAL TRANSPLANT IN A CHILD WITH BILATERAL WILMS’ TUMOR NATIONAL PREMIERE

Introduction: Bilateral Wilms’ tumors with an unfavorable histology require a combined treatment (extensive surgery, polychimiotherapy, radiotherapy). Objective: Presentation of the first renal transplant performed in Romania in a child with bilateral Wilms’ tumor, at 3 years and 4 months after the end of a multimodal treatment. Material and methods: Patient C. N., born on 30.04.1998, was diagnosed in 04.2001 with right parenchymal renal tumor, polycystic kidney, left cystic renal tumor. 25.04.2001 - right radical nephrectomy and partial left upper pole nephrectomy; histopathology examination: triphasic bilateral nephroblastoma, reactive lymph nodes, negative resection edges in the left kidney. 30.04-19.11.2001- polychemotherapy according to the NWTS-5 stages 2-4 focal anaplasia and radiotherapy of the right kidney bed (29.06.2001). 02.2002- a nephrotic syndrome on the remnant kidney which requires its excision and peritoneal dialysis. Abdominal control CT was normal in 03.2005. 11.03.2005- renal transplant from living related donor. Results: Favorable post-transplant course with normal renal clearance values; at 2 months, normal urography control. Conclusions: The tumor pathology does not represent an absolute contraindication for renal transplantation. For the cases with extensive surgery, polychimiotherapy and radiotherapy correctly applied, a pre-transplant “tumor-free” period of at least 2 years is compulsory.