Kidney Transplantation during the First Year of COVID-19 Pandemic in Our Center.

INTRODUCTION: SARS-CoV2 pandemic has altered the normal activity in our day-to-day life. During the most critical moments of the pandemic at the hospital, attendance and programmed activities had to be reduced to a minimum, including kidney transplants. Hospitals with this kind of activity had to suspend or restructure it due to the decrease in the number of donors with a solid organ donation profile, the lack of knowledge as to whether the disease could be transmitted through transplantation or the risk that was believed to be associated with the admission of patients with end-stage chronic kidney disease or immunosuppressive treatment. METHODS: A retrospective review of all patients who had received a kidney transplant at Doctor Peset University Hospital in Valencia was performed from March 2020 to March 2021. The objective was to study the safety of kidney transplantation and the incidence of COVID-19 disease in kidney transplant patients during this pandemic period. RESULTS: 56 cases of kidney transplantation were included, most of them male with an average age of 56 years old, and variable comorbidity such as hypertension, dyslipidemia, an average body mass index of 26 and undergoing renal replacement therapy by hemodialysis. Regarding the organ donors, more than 50% were male patients and the donation was in encephalic death. The average cold ischemia time was 15 hours. Postoperative complications were mostly graded I and II in the Clavien-Dindo classification. 5.4% of the recipients had passed the SARS-CoV2 infection prior to the transplant and 5.4% were infected with COVID-19 after the transplant. CONCLUSION: In our experience, the current kidney transplant program seems viable and safe, even during periods of health emergencies.

Urinoma secondary to ureteropelvic junction obstruction in the neonate. Presentation of a case and bibliographic review.

OBJECTIVE: To analyze the management of prenatal urinoma and ureteropelvic junction obstruction (UPJO) postnatally by a case report and literature review. METHODS: We report a case of an UPJO and urinoma in a newborn. After birth, renal function was absent, and nephrectomy was performed. The literature from 1985 to date has been reviewed. DISCUSSION: By the analysis of the literature, we can observe mainly, that prenatally diagnosed urinoma and UPJO are managed conservatively. After birth, different attitudes have been carried out, independently of residual renal function, such as radical or reconstructive surgery, or conservative treatment. CONCLUSION: Intrauterine management is not indicated. Urinary diversion is indicated in symptomatic cases secondary to renal trauma or endoscopic procedure. In non-functional kidney, nephrectomy is indicated.

Urinoma secundario a estenosis de la unión pieloureteral en el neonato. Presentación de un caso y revisión de la literatura / Urinoma secondary to ureteropelvic junction obstruction in the neonate. Presentation of a case and bibliographic review

OBJETIVO: Analizar el manejo del urinoma prenatal y de la estenosis de la unión pieloureteral postnatalmente mediante el estudio de un caso y revisión bibliográfica. MÉTODOS: Se presenta el caso de neonato con EUPU y urinoma. Se comprueba función renal anulada, realizándose nefrectomía. Se ha revisado la literatura desde 1985 hasta la actualidad. DISCUSIÓN: Analizando la literatura, se observa mayoritariamente que el tratamiento de la EUPU y urinoma prenatales es conservador. Tras el nacimiento existen diversas actitudes, independientemente de la función renal remanente, como son la cirugía radical, la reconstructiva o el tratamiento conservador. CONCLUSIONES: La manipulación intraútero no está indicada sistemáticamente. La derivación urinaria sólo en casos sintomáticos y los secundarios a traumatismo o manipulación endoscópica. En riñones anulados estaría indicada la nefrectomía (AU)

OBJECTIVE: To analyze the management of prenatal urinoma and Ureteropelvic Junction Obstruction (UPJO) postnatally by a case report and literature review. METHODS: We report a case of an UPJO and urinoma in a newborn. After birth, renal function was absent, and nephrectomy was performed. The literature from 1985 to date has been reviewed. DISCUSSION: By the analysis of the literature, we can observe mainly, that prenatally diagnosed urinoma and UPJO are managed conservatively. After birth, different attitudes have been carried out, independently of residual renal function, such as radical or reconstructive surgery, or conservative treatment. CONCLUSION: Intrauterine management is not indicated. Urinary diversion is indicated in symptomatic cases secondary to renal trauma or endoscopic procedure. In non-functional kidney, nephrectomy is indicated (AU)

Large-cell neuroendocrine carcinoma of prostate. Case report.

OBJECTIVE: To report a case of a neuroendocrine differentiation in a prostate cancer patient, a rare subtype. METHODS: We describe the case of a patient diagnosed with adenocarcinoma of the prostate initially, who presented hematuria due to disease progression with neuroendocrine differentiation despite androgen-deprivation therapy (ADT ). DISCUSSION: Prostate cancer is the most common tumor in men. Histologically they are diagnosed as adenocarcinomas, which followed by ADT for a long time, develop neuroendocrine differentiation (NED ). CONCLUSIONS: The prognostic significance of NED remains controversial. We must think in neuroendocrine differentiation in ADT-treated patient with disease progression and low PSA.

Carcinoma neuroendocrino de célula grande prostático. A propósito de un caso / Large-cell neuroendocrine carcinoma of prostate. Case report

OBJETIVO: Presentar un caso de cáncer de próstata con diferenciación neuroendocrina de célula grande, un subtipo muy infrecuente. MÉTODOS: Se describe el caso clínico de un paciente previamente diagnosticado de adenocarcinoma de próstata que debuta con hematuria como progresión de la enfermedad hacia diferenciación neuroendocrina a pesar del tratamiento hormonal. DISCUSIÓN: el cáncer de próstata es el tumor más frecuente diagnosticado en el varón. Histológicamente son diagnosticados de adenocarcinoma de próstata, que tras tratamiento hormonal durante largo tiempo desarrollan una diferenciación neuroendocrina (DNE). CONCLUSIONES: el significado pronóstico de la DNE sigue siendo controvertido. Debemos pensar en la diferenciación neuroendocrina ante un paciente en tratamiento con bloqueo hormonal, con progresión de la enfermedad, y PSA bajo (AU)

OBJECTIVE: To report a case of a neuroendocrine differentiation in a prostate cancer patient, a rare subtype. METHODS: We describe the case of a patient diagnosed with adenocarcinoma of the prostate initially, who presented hematuria due to disease progression with neuroendocrine differentiation despite androgen-deprivation therapy (ADT).DISCUSSION: Prostate cancer is the most common tumor in men. Histologically they are diagnosed as adenocarcinomas, which followed by ADT for a long time, develop neuroendocrine differentiation (NED). CONCLUSIONS: The prognostic significance of NED remains controversial. We must think in neuroendocrine differentiation in ADT-treated patient with disease progression and low PSA (AU)

Dolor y masa gigante en hipocondrio derecho / Right hypochondrium pain and giant mass

OBJETIVO: Describir un caso de una masa gigante en hipocondrio derecho en un paciente de 40 años. MÉTODOS: Describimos un caso de un paciente de 40 años que consultó por dolor en hipocondrio derecho y aumento del perímetro abdominal. En el estudio radiológico se apreció una masa retroperitoneal de 30 x 24 x 20 cm, dependiente del polo superior del riñón derecho. RESULTADOS: Se realizó nefrectomía radical por laparotomía media. El análisis microscópico demostró que se trataba de un carcinoma renal de células claras pT2bM0N0. CONCLUSIÓN: Existen pocos casos publicados de carcinomas renales con hemorragia intraparenquimatosa mayores de 20 cm, el mayor de ellos, de más de 10 kg, y presentan generalmente una evolución favorable(AU)

OBJECTIVE: To report a case of a right hypochondrium giant mass in a 40-year-old patient. METHODS: We report the case of a 40 year-old male referred to our Department because of right hypochondrium pain and increased abdominal perimeter. Radiological examination showed a 30 x 24 x 20 cm retroperitoneal mass, dependent on the upper pole of the right kidney. RESULTS: We performed radical nephrectomy through a mid line laparotomy. The pathological analysis described it as a clear cell renal carcinoma pT2bN0M0. CONCLUSION: There are few reported cases of renal carcinomas with intraparenchymal bleeding exceeding 20 cm, the largest one exceeding 10 kg, and they usually show a good prognosis(AU)

Right hypochondrium pain and giant mass.

OBJECTIVE: To report a case of a right hypochondrium giant mass in a 40-year-old patient. METHODS: We report the case of a 40 year-old male referred to our Department because of right hypochondrium pain and increased abdominal perimeter. Radiological examination showed a 30 × 24 × 20 cm retroperitoneal mass, dependent on the upper pole of the right kidney. RESULTS: We performed radical nephrectomy through a mid line laparotomy. The pathological analysis described it as a clear cell renal carcinoma pT2bN0M0. CONCLUSION: There are few reported cases of renal carcinomas with intraparenchymal bleeding exceeding 20 cm, the largest one exceeding 10 kg, and they usually show a good prognosis.