Nephrectomy (transplant or non-neoplastic)

Auto text: “Insert Transplant Nephrectomy”

These specimens are signed out by the Medical Renal service. Consult Renal attendings with questions.

Triage

  1. Weigh and measure specimen in 3 dimensions.
  2. Measure length and diameter of attached ureter and vessels.
  3. If a mass is suspected/palpated, ink the outer surface of the kidney adjacent to the mass.
  4. Take circumferential “en face” margins of distal ureter, renal arteries, renal veins.  Place in cassette and keep it in container.
  5. Open the ureter longitudinally to examine for lesions.
  6. Bisect kidney through renal hilus and surrounding perinephric fat.
  7. Identify and measure adrenal, if present.
  8. Identify and measure kidney, including cortical thickness.
  9. Section each half of the kidney in 1 cm slices.
  10. Examine kidney for any cysts or masses. Measure range of cyst sizes and any masses in 3 dimensions.
  11. Overnight formalin fixation is optional.  Specimen can be grossed same day.

Gross

  1. Describe the consistency of the kidney, paying particular attention to the cortex and renal vessels at the hilum.
  2. Describe the subcapsular surface and features observed on the cut surface.
  3. Submit representative sections of cortex, medulla and pelvis.
  4. If masses are identified, submit representative sections of mass including closest to inked outer margin.  See Neoplastic Nephrectomy for more details.

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