Non-skin malignancies after renal transplantation

Background: During the last several decades, renal transplantations (RT) have been performed with an increasing success. However, RT recipients are predisposed to greater number of late complications including neoplasia caused by graft-preserving immunosuppressive therapy. The objective of the research was to estimate the number and the type of de novo cancers among kidney grafts recipients.
Material/Methods: We reviewed medical records of 913 patients (568 males and 345 females) who underwent RT in our transplantation centre between 1980 and 2008.
Results: During the follow-up 30 (3.3%) RT recipients were diagnosed with
non-skin malignancies. 4 lymphomas and 26 solid malignancies were recognized (7 genitourinary, 5 lung, 4 gastrointestinal, 3 liver, 2 breast, 1 pancreas, 1 brain, 1 larynx, 1 suprarenal gland and 1 of unknown origin).Affected group included 23 (76%) males and 7 (24%) females, they mean age at diagnosis was 54.3±13 (range 24-79) years. The mean time since transplantation to cancer diagnosis was 66.2±58.9 (range 6-228) months. The immunosuppressive protocol consisted of: prednisone (P) azathioprine (AZA) cyclosporine A (CsA) in 14 (46%) patients, mycophenolate mofetil (MMF) tacrolimus (TAC) in 6 (20%) patients; CsA MMF in 4 (13%) patients, AZA in 1 (3.3%) patient; CsA in 3 (10%); TAC in 1 (3.3%) patient and TAC alone in 1 (3.3%) patient. Twelve (40%) patients died. All patients with lymphoma died (8-44 months after diagnosis). Four (13%) patients lost their grafts due to cancer.
Conclusions: Genitourinary cancer, lung cancer and lymphoma were diagnosed most frequently. Almost 50% of cancer patients received P, AZA and CsA. Life expectancy after cancer diagnosis was short.

Keywords: Kidney Transplantation