Clinical analysis of malignant tumors in recipients of renal transplantation / 中华泌尿外科杂志

ABSTRACT

Objective To investigate the occurrence,types and therapeutic effect of malignancies in renal allograft recipients. Methods A retrospective study of 1200 renal allograft transplantations in 1189 patients performed between July 1977 and September 2001 was carried out. Results After transplantation among the 1189 recipients,19 cases (an incidence rate of 1.6%) were diagnosed with malignancies,including hepatocarcinoma in 4 cases,breast cancer in 3,Kaposi sarcoma in 2,lung cancer in 2,and squamous carcinoma of bladder,non-Hodgkin lymphoma,stomach carcinoma,carcinoma of head of pancreas,carcinoma of gingival,colon carcinoma,gallbladder carcinoma each in 1,and 1 intensive metastasis case without concerned source.The mean postoperative duration of immunosuppressive treatment before the diagnosis of malignancies was (36.7?24.2)months (range,2 to 112 months).Surgical operations were performed in 12 cases,all of whom survived with normal renal function.A mean follow-up of 15.4 months (range,1 to 73 months) showed that no recurrent malignancy developed and no rejection of transplanted kidneys occurred.Five of the 7 cases who had malignancies at advanced stage and lost surgical treatment opportunity died within 1 year after the diagnosis. Conclusions The incidence of malignancy in renal allograft recipients is much higher than normal population,closely related to the long term use of immunosuppressants.Radical surgery of the malignancies is preferred option and use of immunosuppressants can be reduced or discontinued;meanwhile the function of the transplanted kidney should be maintained as much as possible.