Early diagnosis of cancer in renal transplant patients: a single center experience.

ABSTRACT

Renal transplantation confers increased survival with improvement of immune suppressive drugs, but certain types of neoplasm can arise as secondary complications. It is thus well known that recipients have significantly increased risk of developing de novo malignancy when compared with the age-matched general population. Cancer is the 4th most common cause of death in transplant patients after cardiovascular disease, infections and liver failure. Our transplantation team has performed 1,582 kidney transplantations since 1975. Fifty-nine of the patients developed malignancies in the posttransplantation period. The most common was Kaposi's sarcoma (19 patients, 32.2 %), followed by lymphomas (16 patients, 27.1 %) and skin carcinomas (13 patients, 22.0 %). Many factors can contribute to high susceptibility in these patients; age at transplantation, certain types of viral infections like Epstein-Barr virus, human herpes virus-8, human papilloma virus or chronic usage of immune suppressive agents, type of immune suppressive drugs, and ethnic characteristics. Transplant recipients generally have advanced stage cancers at the time of diagnosis with a poor prognosis. Since some neoplasms are common early detection of cancer is important to decrease cancer related mortality and morbidity. This article considers risk factors and recommendations for early diagnosis of cancer in renal transplant patients.