To summarize the experience and key points of living relative kidney transplantation after resection of a small renal cancer.

Retrospective analysis was performed on the clinical data and postoperative outcome of a case of living relative kidney transplantation after resection of a small cancer January 2016 in Zhongshan Hospital, Fudan University. The donor was the mother of recipient, CT angiography showed that there was a round spot (16 mm×15 mm) on the bottom of right kidney which was thought to be small renal carcinoma. Donor kidney was harvested through 11th-rib supracostal incision. Then it was washed and perfused with preservation solution. The tumor in the living donor kidney was resected and sent for intra-operational pathological examination and the tumor-resected kidney was subsequently used for kidney transplantation after no edge infiltration was confirmed.

Post-operative pathological examination showed that the histologic type of the tumor was clear cell carcinoma and no carcinoma tissue was found in renal capsule. Basiliximab was used to immunosuppression induction before bloodstream was opened intranperative and 4 days after operation. The immunosuppressive therapy included tacrolimus+ mycophenolate+ prednisolone in 3 months after operation and tacrolimus switched to rapamycin later. Besides the regulatory examination, the recipient also received doppler ultrasound examination. The recipient was followed for 6 months until July 2016. No space-occupying lesion was found during follow-up and the function of the transplant kidney was stable.

With strict assessment and pathological confirmation, donor kidneys with a small cancer, once resected, can serve as a donor kidney in transplantation with good expectations. This may become an effective approach in increasing the source of donor kidney.