[Tumors and kidney transplantation]

Incidence and type of de novo tumours were studied retrospectively in 187 consecutive patients who had received kidney transplants between 1967 and 1981 and undergone immunosuppressive therapy for 2 months or longer. Up to the end of June 1983, 18 patients (9.6%) had developed 22 malignancies and 7 of them had died from the tumour. The risk of developing a malignancy appeared to increase with prolonged immunosuppression. No significant difference was noted between patients with and without tumours regarding primary renal disease, duration of pretransplant dialysis, and type or total dose of immunosuppressive drugs. The risk of developing any malignancy appeared to be some 20 times that in the general population. The practical management of patients with de novo tumours is described in the light of our own patient material and the recent literature. Finally, two further oncological problems are discussed: first, the incidental grafting of malignant cells with the transplant, and second, how to proceed in a transplant candidate with a previous malignancy.