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Malignant tumours after renal transplantation
11st Department of Surgery, Semmelweis University Medical School, Budapest, Hungary.
Acta Chirurgica Hungarica
|January 1, 1992
Summary
Kidney transplant recipients have a 20-30 times higher risk of developing malignant tumors, primarily skin cancers, due to immunosuppression. This risk persists even with newer Cyclosporine-based therapies.
Area of Science:
- Nephrology
- Oncology
- Immunology
Background:
- Kidney transplantation is a life-saving procedure for end-stage renal disease.
- Immunosuppressive therapy is crucial for graft survival but is associated with increased cancer risk.
- Previous studies indicate a higher incidence of malignancies in transplant recipients.
Purpose of the Study:
- To examine the incidence of malignant tumors in kidney transplant patients.
- To compare cancer risk between conventional (AZA+PRED) and Cyclosporine-based (CYA+PRED) immunosuppressive regimens.
- To highlight the oncogenetic effects of immunosuppression in kidney transplant recipients.
Main Methods:
- Retrospective analysis of 570 kidney transplant patients.
- Incidence rates of various malignancies were calculated and compared to the general population.
- Comparison of cancer types and frequencies between different immunosuppressive treatments.
Main Results:
- Malignant tumor incidence was 20-30 times higher than in the general population.
- Skin cancers were the predominant malignancies observed.
- A lower than expected number of lymphoreticular malignancies was noted.
- Cyclosporine (CYA+PRED) therapy, while generally favorable, did not eliminate the increased cancer risk.
Conclusions:
- Immunosuppression significantly increases the risk of oncogenesis in kidney transplant patients.
- The oncogenetic risk associated with immunosuppression warrants consideration even with modern therapies like Cyclosporine.
- Monitoring for malignancies, particularly skin cancers, is essential in long-term kidney transplant survivors.