Supplementary Material for: Timing of renal transplant in survivor children with relapse of Wilms tumor, a case series study

IIntroduction: Children with Wilms tumor can rarely experience late relapse of disease. Sometimes bilateral nephrectomy is necessary, as consequence, patient needs hemodialysis waiting for renal transplantation. The waiting time to transplantation after cancer has always been debated issue. Case presentations: We present two cases of late relapse of Wilms tumor underwent bilateral nephrectomy. Patient 1 was put in the attending list for renal transplant after 5 years to the stop treatment, attending the conventionally time; however she died before transplant because of complications in Sars-Covid-19 infection. Patient 2 underwent to 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 in multidisciplinary team. In our cases the different time to renal transplantation was associated to different outcome. 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 timing of renal transplant; in this view collaboration between oncology centres is strongly required