Genitourinary tumors and liver transplantation: A comprehensive review

Table 1 Possible proposal of acceptable liver donors with history of or current genitourinary malignancy (adapted from[15])

Minimal risk	Low to intermediate risk	High risk	Unacceptable risk
Current
NMIBC – in situ and T1	Prostate cancer-Gleason score 7	Prostate cancer- Gleason score >7	Metastatic prostate cancer
Prostate cancer - Gleason score ≤ 6	RCC 1-4 cm and Fuhrman grade I/II	RCC > 7 cm and Fuhrman grade III/IV	RCC stages T3/T4
RCC < 1 cm and Fuhrman grade I/II	RCC 4-7 cm and Fuhrman grade I/II		MIBC – post chemoradiation
History
Prostate cancer Gleason up to 6 Prostate cancer Gleason = 7 after curative treatment and cancer-free period > 5 yr	RCC 1-4 cm, FG I/II; RCC 4-7 cm, FG I/II	Prostate cancer with extraprostatic spread	Any metastatic genitourinary malignancy
RCC < 1 cm and FG I/II		RCC > 7 cm and FG III/IV	RCC stages T3/T4

RCC: Renal cell carcinoma; NMIBC: Nonmuscle-invasive bladder cancer; MIBC: Muscle-invasive bladder cancer; FG Fuhrman grade.

Table 2 Possible proposal of waiting time until liver transplantation for recipients with a history of genitourinary malignancy (adapted from[29])

Cancer	Tumor stage and/or grade	Time interval to transplant
Prostate	Up to T3 stage and regardless of Gleason score	No wait time
	Metastatic castration-sensitive prostatic cancer	Stable disease for 2 yr with prolonged estimated life expectancy – 2 yr
	Metastatic castration-resistant	Not a LT candidate
Renal cell carcinoma	T1a (≤ 4 cm) and T1b (4-7 cm) with N0, M0 and Fuhrman grade I/II	No wait time
	T1b, N0, M0 and FG III/IV and T2N0M0	2 yr
	T3 and T4 – both N0M0	Minimum 2 yr then reassess
	Any T, N+, M+	Not a LT candidate
Bladder	NMIBC (solitary tumor, low grade, absence of carcinoma in situ (CIS), high grade tumor < 3 cm)	6 mo
	NMIBC (any CIS, high-grade tumor > 3 cm, high grade T1 tumor, any recurrent high-grade Ta tumor, lymphovascular invasion)	2 yr
	MIBC, postradical cystectomy	2 yr
	MIBC, post chemoradiation	Not a LT candidate

FG: Fuhrman grade; LT: Liver transplantation; NMIBC: Nonmuscle-invasive bladder cancer; MIBC: Muscle-invasive bladder cancer.