[Malignancy after renal transplantation: a case series study from Isfahan University]

Long term use of immunosuppressive therapy in transplant recipients in order to prevent acute and chronic rejection increases the long term risk of cancer. This study evaluates the incidence of different organs cancer after renal transplantation and immunosuppressive therapy. This is a retrospective analysis of malignant tumors in renal graft recipients with more than one year graft survival. Patients were assessed according to their age, sex, diagnosis of cancer, immunosuppressive drugs, donors and period of dialysis before transplantation. Evaluating all existing files in selected private clinics in Isfahan 350 patients were reviewed and 289 of them had entrance criteria. A total of 186 men and 103 women [mean age: 42.17 +/- 13.09 years] were included. They were followed up over a mean period of 52.46 +/- 33.24 months. A total of six cases [2.1%] of cancer were diagnosed in six recipients: All patients with cancer were male with a mean age of 51.17 +/- 14.7 years [range: 26-68 years]. Tumor presented at a mean time of 51 months [rang: 15-82 months] after transplantation. There were two patients with BCC, two patients with SCC and two patients with lymphoma. Two patients died of progressive malignant disease. Age, period of dialysis before transplantation, and using immunosuppressive and anti-rejection drugs had no significant impact on development of post transplant malignancy. The frequency of tumors in these patients is lower than what reported by other centers, probably due to short period of follow up and low incidence of cancer in our general population. The risk of malignancy was 28 fold higher among transplant recipients than in general population. High risk of cancer in this group, confirms the necessity of routine examination for organ transplant recipients both before and after transplantation

Response rate to hepatitis B vaccination in patients with chronic renal failure and End-stage-renal-disease: Influence of diabetes mellitus

Hepatitis B vaccination is recommended for all individuals with renal failure. Nevertheless, the response rate for this vaccine in hemodialysis patients is low. This study was designed to determine the response rate to hepatitis B vaccination in chronic renal failure [CRF] and end stage renal disease [ESRD] patients and those factors that influence it. We evaluated antiHBs level after primary vaccination in 32 predialysis and 93 dialysis patients. HBsAg positive patients were excluded. AntiHBs titers were determined in the period of 1 to 6 months after completion of vaccination. Seroconversion [antiHBs >/= 10mIU/ml] was found in 100 patients [80%], but an excellent response [titer>100 mIU/ml] was observed only in 74 [59.2%]. Response rate were 71.9 and 82.8 in predialysis CRF and ESRD patients, respectively, but this difference was not significant [