60 - Safety and Efficacy of Microwave Ablation in Patients with Chronic Renal Insufficiency/End Stage Renal Disease as a Bridge to Renal Transplantation

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Brian Yost, MD

Resident
New York Presbyterian Weill Cornell Medical Center, United States

Author/Co-author(s)

BN

Behnam Nabavizadeh, MD

Resident
New York Presbyterian Weill Cornell Medical Center, United States
BS

Brian W. Sullivan, RA

Radiology Assistant
New York-Presbyterian Hospital/Weill Cornell Medicine, United States
SK

Sandip Kapur, MD

Chief of Transplant Surgery and Director of the Kidney and Pancreas Transplant Programs
New York Presbyterian Weill Cornell Medical Center, United States
JD

Joseph Del Pizzo, MD

Professor of Urology and the Director of the Advanced Minimally Invasive Kidney Donor Program
New York Presbyterian Weill Cornell Medical Center, United States
Tim McClure, MD

Assistant Professor
Weill Cornell Medicine, United States

Purpose:

Evaluate the safety and efficacy of microwave ablation of renal masses in native kidneys in patients with stage 5 chronic renal insufficiency (CRI) and end stage renal disease (ESRD) as a bridge to renal transplantation.

Materials and Methods:

A retrospective analysis was performed of all patients who underwent percutaneous biopsy and microwave ablation of native renal masses at a single institution between October 2016 and August 2022. Patients with Cr > 3 mg/dL and GFR < 15 mL/min (CRI) and patients on hemodialysis (ESRD) before ablation were included. Lesion pathology, rates of complication, recurrence, development of metastases and renal transplant were analyzed.

Results:

272 total ablations were performed in 261 patients. 40 biopsies (same day biopsy n = 34; prior biopsy n = 6) and ablations were performed in 37 patients who met criteria (CRI n = 26; ESRD n = 11), with results being: Renal cell carcinoma clear cell or papillary n = 23 (58.9%); Benign n = 10 (25.6%); Oncocytic n = 4 (10.2%); Other malignant n = 2 (5.1%).

3 of 40 ablations required renal angiography and/or embolization (7.5%), 1 patient had a perinephric hematoma that was managed conservatively (2.5%). 2 patients had minor medical complications. Follow-up imaging was used with CT or MRI. Follow-up time was defined as the time of ablation to last imaging (range1-81 months, mean of 24.4 months). Primary treatment efficacy of ablation was 95% and 2 patients underwent repeat ablation for residual enhancement. No patients had local recurrence or interval development of metastatic disease at final follow-up. 1 patient had evidence of pulmonary metastatic disease on pre-ablation imaging which was treated with ablation. 3 patients developed new lesions (ipsilateral native kidney n = 1; contralateral native kidney n = 1; transplant kidney n = 1), which were treated with nephrectomy or ablation. Overall, 7 of 37 (18.9%) patients went on to renal transplantation.

Conclusion:

Percutaneous microwave ablation is a safe and effective treatment for native renal masses in patients with CRI and ESRD and should be considered in this patient population as a bridge to renal transplantation.