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Renal cancer in recipients of kidney transplant

Prajwal Dhakal, Smith Giri, Krishmita Siwakoti, Supratik Rayamajhi, Vijaya Raj Bhatt
  • Prajwal Dhakal
    Michigan State University, East Lansing, MI, United States | prazwal@gmail.com
  • Smith Giri
    The Yale New Haven Hospital, New Haven, CT, United States
  • Krishmita Siwakoti
    University of Tennessee, Memphis, TN, United States
  • Supratik Rayamajhi
    Michigan State University, East Lansing, MI, United States
  • Vijaya Raj Bhatt
    University of Nebraska Medical Center, Omaha, NE, United States

Abstract

The aim of our study is to determine characteristics and outcomes of kidney cancer in renal transplant recipients. MEDLINE ® database was searched in June 2015 to identify cases of kidney cancer in renal transplant recipients. We include also a new case. Descriptive statistics were used for analysis. Forty-eight (48) recipients reported in 25 papers met the eligibility criteria. The median age was 47 years (range 9-66); 27% were females. Chronic glomerulonephritis, cystic kidney disease and hypertension were common indications for renal transplant. Among donors 24% were females and the median age was 52.5 years (17- 73); 62% of kidney cancers were donor-derived. The median interval between transplant and cancer diagnosis was shorter for cancer of recipient versus donor origin (150 vs. 210 days). Clear cell carcinoma was diagnosed in 17%. 25% had metastasis at diagnosis. Kidney explantation or excision was done in 90% and 84% of cases with and without metastasis respectively. The median survival was 72 months. Actuarial 1-year and 5-year survival rates were 73.4% and 55.1% respectively. Among the recipients from 7 donors who subsequently developed malignancy, 57% were dead within a year. Kidney transplant recipients have a small risk of kidney cancer, which affects younger patients and occurs within a year of transplant, likely due to immunosuppression. Whether the use of older donors may increase the likelihood needs further investigation. The presence of metastasis, explantation or excision of affected kidney and development of cancer in donors predict outcomes. The results may guide patient education and informed decision-making.

Keywords

Kidney cancer; transplant; kidney transplant; recipients

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Submitted: 2016-04-20 05:11:57
Published: 2017-03-24 11:09:27
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Copyright (c) 2017 Prajwal Dhakal, Smith Giri, Krishmita Siwakoti, Supratik Rayamajhi, Vijaya Raj Bhatt

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