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Kaposi's sarcoma: the most common tumor after renal transplantation in Saudi Arabia
1Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Abstract:
Between September 1975 and November 1986, 263 renal transplant recipients at the King Faisal Specialist Hospital and Research Center were followed; 82 procedures were done by the authors using live related donors. Among the 263 patients, 14 cases of Kaposi's sarcoma were identified, an incidence of 5.3 percent compared with an incidence of 0.4 percent in renal transplant recipients from Western countries. In addition, two more patients had other types of tumors. Thus, Kaposi's sarcoma represents 87.5 percent of tumors in the King Faisal Hospital renal transplant population, in contrast to 3.7 percent in the Cincinnati Transplant Tumor Registry. The mean period between transplantation and diagnosis of Kaposi's sarcoma was 12.5 months (range, one to 37 months). Eleven patients were Saudis and three were other Arab nationals. Seven of the 11 Saudi patients were from the southwestern region of the country. Cytomegalovirus titers were not elevated in six of 10 patients. Results of tests for human immunodeficiency virus were negative in seven of eight patients. HLA-A2 antigen frequency was significantly increased in the King Faisal Hospital renal transplant patients with Kaposi's sarcoma as compared with a control population (83.3 percent versus 43.6 percent, p value = 0.006 [P = 0.06 with Bonferroni adjustment]), and increased, though nonsignificantly, compared with the live related kidney transplant recipients without Kaposi's sarcoma (83.3 percent versus 49.4 percent, p value = 0.058 [P = 0.58 with Bonferroni adjustment]), suggesting a genetic predisposition to Kaposi's sarcoma in these patients.
Insights
Renal transplant recipients in Saudi Arabia showed a significantly higher incidence of Kaposi's sarcoma (KS) compared to Western countries. This suggests a potential genetic predisposition, possibly linked to the HLA-A2 antigen, in developing KS post-transplantation.
Area of Science:
- Nephrology
- Oncology
- Immunology
Background:
- Renal transplantation is associated with an increased risk of certain malignancies.
- Kaposi's sarcoma (KS) is a notable post-transplant malignancy, particularly in specific geographic regions.
- Understanding the incidence and risk factors for KS in renal transplant recipients is crucial for patient management.
Purpose of the Study:
- To determine the incidence of Kaposi's sarcoma (KS) in renal transplant recipients at King Faisal Specialist Hospital and Research Center (KFSH&RC) between 1975 and 1986.
- To compare this incidence with that reported in Western countries.
- To investigate potential risk factors, including genetic predisposition (HLA-A2 antigen), for KS development in this population.
Main Methods:
- A retrospective review of 263 renal transplant recipients followed at KFSH&RC.
- Identification and analysis of tumor types, with a focus on Kaposi's sarcoma.
- Comparison of KS incidence with data from the Cincinnati Transplant Tumor Registry and Western populations.
- Analysis of patient demographics, transplantation details, and HLA-A2 antigen frequency.
Main Results:
- An incidence of 5.3% for Kaposi's sarcoma was observed in KFSH&RC renal transplant recipients, significantly higher than the 0.4% in Western countries.
- Kaposi's sarcoma accounted for 87.5% of tumors in this cohort, compared to 3.7% in the Cincinnati registry.
- A significantly increased frequency of the HLA-A2 antigen was found in KFSH&RC patients with KS compared to controls (83.3% vs. 43.6%, p=0.006).
Conclusions:
- Renal transplant recipients at KFSH&RC exhibit a markedly elevated incidence of Kaposi's sarcoma.
- The findings suggest a potential genetic predisposition to KS in this population, with a notable association with the HLA-A2 antigen.
- Further research is warranted to elucidate the specific genetic and environmental factors contributing to KS development in this demographic.