Kidney transplantation in patients with history of malignancy: Time to rethink the guidelines?

A history of malignancy is often considered a contraindication for kidney transplantation. While the desire to transplant a 'cancer-free' patient is understandable, the current approach neglects the heterogeneity in the natural history of cancers, even within a given tumor type. The information used to formulate current guidelines are dated and fail to reflect the vast resource of modern oncology clinical trials data that should more accurately predict the expected overall survival and recurrence risk of cancer patients. The expected survival for many cancer patients excluded by current guidelines compares favorably with other conditions considered acceptable for transplantation. This review will suggest that close collaboration between transplant teams and oncologists can increase the appropriate use of renal transplantation in cancer patients.