The Risk Of Post-transplant Malignancy

Abstract

Introduction. Transplantation-related malignancies have become a major cause of post-transplant complications. Localization of a cancer in a renal graft is rare and needs a complex approach.

Objective. To assess the prevalence of the post-transplant malignancy and the characteristics of malignancies located on the renal graft.

Method. We performed a retrospective study on 827 patients transplanted in our institution between January 2000 and December 2010. Recipients were classified according to the immunological risk and the type of immune suppression received. The treatment of malignancies located at the renal graft aimed at preserving the renal graft function.

Results. The overall de novo malignancy prevalence was 9.43%, higher for the TMP group (10.98%) and lower for the CMP group (5.93%), p<0.0223. The prevalence of malignancies affecting the renal graft was 1.09 (9 cases). Renal cell carcinoma accounted for 2 cases and PTLD for 0.85% (7 cases). In the case of malignancy of the renal graft, the mean time from transplantation to diagnosis was 11.33 months (range 4-18 months) for PTLD and 33.67 months (range 17-60 months) for renal cell carcinoma.

Conclusion. The use of tacrolimus increased the standardized incidence ratio of post-transplantation malignancies. Induction with polyclonal antibody is associated with an increased risk for malignancy.