Posttransplant Kaposi's sarcoma: report from a single center

Posttransplant Kaposi's sarcoma (KS) is not uncommon. This study investigated the clinical manifestations, impact of immunosuppression, and presence of HHV-8 antigen in our patients.

Among 568 renal transplant recipients, four developed KS. The physical findings, radiologic studies, immunosuppressive regimens, and the clinical outcomes were reviewed. In two patients, the expression of human herpes virus-8 was examined with polymerase chain reaction and in situ hybridization.

The incidence of KS was 0.7% in our recipients. The intervals between the transplantation and the development of KS ranged from 2 months to 8.4 years. All KS patients had calcineurin inhibitor-based antirejection therapies. Peripheral lymphadenopathy was the initial manifestation in three of four patients; the fourth presented with violaceous papules over his lower legs. Besides lymphadenopathy, KS in one patient also involved internal visceral organs. One patient died at the time of diagnosis because of Salmonellosis; the other three experienced tumor regression after discontinuation of calcineurin inhibitors. HHV-8 expression was detected in two examined specimens.

Lymph node involvement is the most common clinical presentation in our posttransplant KS patients. HHV-8 infection is associated with the development of KS. Early withdrawal of calcineurin inhibitors produces a favorable outcome in posttransplant KS.