Related Experiment Video
Updated: Aug 10, 2026
Non-invasive Imaging of Acute Allograft Rejection after Rat Renal Transplantation Using 18F-FDG PET
Published on: April 28, 2013
Primary kidney tumors before and after renal transplantation
1Department of Surgery, University of Cincinnati Medical Center, Ohio.
Abstract:
Three groups of patients were reviewed. Primary carcinomas were found in donors kidneys of 47 recipients. In 30 instances a tumor was present at harvesting. When a neoplasm was removed immediately pretransplantation or early posttransplantation there were no recurrences in 14 recipients. In another two instances, a tumor was not removed or was incompletely excised pretransplantation and both recipients died of metastases. Fourteen other patients received kidneys from donors in whom the opposite kidney had a malignancy. Thirteen remained tumor-free and one had allograft nephrectomy for rejection 3 months posttransplantation when a carcinoma was found. In 17 recipients an allograft neoplasm was not recognized at harvesting. In 9 it was discovered at graft nephrectomy an average of 3 months posttransplantation. In a tenth patient a hypoechogenic area, found on routine posttransplant ultrasonography, progressively increased in size and proved to be malignant. Another 7 patients developed metastases from renal carcinomas an average of 12 months posttransplantation. Preexisting carcinomas were found in 350 recipients. Seventy-one patients with incidentally discovered tumors had no recurrences no matter when nephrectomy was performed in relationship to transplantation. Of 279 patients with symptomatic renal tumors, 70 (25%) had recurrences, 63% of which occurred in patients treated < or = 2 years pretransplantation. De novo cancers were found posttransplantation in 256 recipients. Renal carcinomas were 4.6% of posttransplant cancers compared with 3% of tumors in the general population. In 222 patients their own diseased kidneys were involved, in 24 tumors occurred in the allograft, and in 10 cases the site was not stated. Development of neoplasia seemed to be related not to the immunosuppressive therapy but to the underlying cause of renal failure, especially analgesic nephropathy. A disproportionate number of carcinomas (15%) involved the renal pelvis, most likely because of prior analgesic abuse.
Insights
Kidney transplant recipients with cancer face risks, but timely tumor removal and managing underlying kidney disease can improve outcomes. Careful monitoring is crucial for detecting and treating post-transplant cancers.
Area of Science:
- Nephrology
- Oncology
- Transplantation Medicine
Background:
- Kidney transplantation is a life-saving procedure, but cancer risk in recipients and donors is a concern.
- Understanding the incidence and outcomes of various cancers in kidney transplant patients is vital for improving care.
Purpose of the Study:
- To analyze the outcomes of kidney transplant recipients with primary, preexisting, and de novo cancers.
- To investigate the relationship between cancer development and immunosuppression versus underlying renal disease.
Main Methods:
- Retrospective review of three groups of kidney transplant recipients: those receiving kidneys from donors with primary carcinomas, those with preexisting carcinomas, and those developing de novo cancers.
- Analysis of tumor detection timing, treatment, recurrence rates, and survival outcomes.
Main Results:
- Tumors in donor kidneys: no recurrences if removed early; metastases if incompletely removed. Kidneys from donors with contralateral malignancy had good outcomes.
- Preexisting symptomatic tumors had a 25% recurrence rate, especially if treated close to transplantation. Incidental tumors had no recurrences.
- De novo cancers occurred in 4.6% of recipients, often linked to underlying renal failure (e.g., analgesic nephropathy) rather than immunosuppression. Renal pelvis cancers were disproportionately represented.
Conclusions:
- Early detection and complete removal of tumors in donor or recipient kidneys are critical for preventing recurrence.
- Underlying causes of renal failure, particularly analgesic nephropathy, appear to be significant risk factors for cancer development post-transplantation.
- Close monitoring and management of patients with a history of cancer or risk factors for renal disease are essential in kidney transplantation.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:29Acute Kidney Injury III: Clinical Manifestations