Timing of Renal Transplant in Survivor Children with Relapse of Wilms Tumor: A Case Series Study.

Introduction: Children with Wilms tumor can rarely experience late relapse of disease. Sometimes bilateral nephrectomy is necessary; as a consequence, the patient needs hemodialysis while waiting for renal transplantation. The waiting time to transplantation after cancer has always been a debated issue. Case Presentation: We present 2 cases of late relapse of Wilms tumor who underwent bilateral nephrectomy. Patient 1 was put in the attending list for renal transplant after 5 years to stop treatment, attending the conventional time; however, she died before transplant because of complications in SARS-COVID-19 infection. Patient 2 underwent a renal transplant sooner compared to the conventional time, improving her quality of life and alive. Conclusion: If bilateral nephrectomy is necessary in oncological patients, the timing of renal transplant should be discussed by multidisciplinary team. In our cases, the different time to renal transplantation was associated with different outcomes. Clinicians should have common lines about the time of renal transplantation in pediatric oncology; however, a personalized planning could be suggested after discussion among specialists, evaluating case to case. The presented field needs more knowledge and further larger case series are necessary to evaluate outcome related to the timing of renal transplant; in this view, collaboration between oncology centers is strongly required.