[Kaposi's sarcoma after kidney transplantation]

Area of Science:

• Immunosuppression and Oncology
• Transplantation Medicine
• Dermatology

Background:

• Post-transplant lymphoproliferative disorders (PTLD) are a known complication following organ transplantation.
• Kaposi's sarcoma (KS) is a PTLD associated with human herpesvirus 8 (HHV-8) infection, often seen in immunosuppressed individuals.
• Management of PTLD typically involves reducing immunosuppression and/or antiviral therapy.

Observation:

• A 44-year-old male developed cutaneous Kaposi's sarcoma with nodular and follicular lesions nine months post-haplo-identical kidney transplantation.
• The patient was on a regimen of methylprednisolone and cyclosporin A, with no evidence of HIV.
• No visceral involvement of the Kaposi's sarcoma was detected.

Findings:

• Reducing the dosage of methylprednisolone and cyclosporin A halted the progression of skin lesions while maintaining kidney transplant function.
• Radiotherapy (48 Gy) led to regression of lesions in the lower legs.
• Recurrence of Kaposi's sarcoma ten months later required additional radiotherapy, which controlled growth without impacting transplant function.

Implications:

• Immunosuppression reduction is a key strategy in managing post-transplant Kaposi's sarcoma.
• Radiotherapy can be an effective treatment modality for cutaneous Kaposi's sarcoma in transplant recipients.
• Careful monitoring and tailored treatment are crucial for managing PTLD while preserving graft function.