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ACKD Transplant Screening — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardTransplantationACKD Transplant ScreeningESENeph

A dialysis patient being assessed for transplantation has an incidental 2.4 cm renal-cell carcinoma confined to a native kidney. It is completely excised with clear margins and staging shows no spread. What waiting-period principle applies?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — No additional cancer-free interval after curative excision and staging

Explanation lettering: B = shown as A · E = shown as B · A = shown as C · C = shown as D · D = shown as E

C is correct. KDIGO’s transplant-candidate guidance treats a curatively treated incidental renal tumour below 3 cm as an exception that does not require an additional cancer-free waiting interval. A and B apply blanket delays without stage-specific risk assessment. D makes a successfully treated low-risk tumour a lifelong contraindication. E omits the crucial requirement for curative treatment and adequate staging before transplantation. The transplant and cancer teams still confirm pathology, margins, metastatic assessment and surveillance. This rule should not be extrapolated to larger, symptomatic, invasive or metastatic RCC, for which recurrence risk changes the timing decision.

Reference: KDIGO 2020 transplant-candidate guideline: https://kdigo.org/wp-content/uploads/2026/04/KDIGO-2020-Transplant-Candidate-Guideline.pdf