De Novo Malignancy in Kidney Transplantation Recipient

Kwon, Kyung Won; Kim, Tae Hee; Kim, Song Cheol; Han, Duck Jong

Abstract

PURPOSE: The incidence of malignancy in kidney transplantation recipient was increased in accordance with the prolonged graft survival due to a development of new immunosuppressive agents. The malignancy is not only lethal to the patients but also imposed the major cause of morbidity and mortality. We analyzed 1) the relationship between the kidney transplanted patients who was operated in our hospital and type of malignancy of them after transplantation 2) treatment and prevention via analysis of risk factors of malignancy after transplantation.
METHODS
The retrospective analysis was performed in 10 patients with malignancy among the 916 patients who underwent kidney transplantation in our hospital from 1990 to 1999 and the 3 patients with malignancy who underwent kidney transplantation in other hospital and followed up in our hospital.
RESULTS
In 916 renal transplant patients, 885 patients were the CsA-based group and the other 31 patients were tacrolimus-based group. In the 13 malignancy patients, 12 were CsA-based group and the other 1 patient was tacrolimus-based group . Mean duration of tumor occurrence after transplantation was 36.2 month (5-80 month). There were 4 squamous epithelial cancer, 2 post-transplant lymphoproliferative disease (PTLD), 2 Kaposi's sarcoma, 2 gastric cancer and 1 breast cancer. There was no difference of interval for tumor development among diverse malignancy. We could not find any predisposing factors for tumor occurrence in this short term observation.
CONCLUSION
Even though there were some epithelial and gastrointestinal tract cancer patients after renal transplantation, there were no specific risk factors which increase the incidence of cancer in immunocompromised patient save the locally endemic occurrence such as GI malignancy.