Early de novo malignancies after kidney transplantation.
BACKGROUND
Immunosuppressed renal transplant patients display a higher incidence of carcinoma than the general population. The chronic use of immunosuppressive therapy to prevent acute rejection increases the long-term risk of cancer. We reviewed our experience to identify factors affecting the development of de novo neoplasms.


METHODS
Between January 2000 and May 2003, 135 renal and three combined kidney-pancreas transplantations were performed.


RESULTS
Sixteen (11.6%) cancers were diagnosed in nine renal transplant recipients (6.5%). Tumors presented at a mean time of 14 months. Three patients displayed in malignancies; three, Kaposi's sarcoma; one, papillary microcarcinoma of the thyroid; one, bladder carcinoma; and one, breast carcinoma.


CONCLUSIONS
Although de novo malignancies occur more frequently many years after kidney transplantation, our experience demonstrates that they can occur early during the posttransplant follow-up. Skin malignancies showed the best prognosis, probably because of early detection and treatment. Patients with Kaposi's sarcoma benefit from reduction or cessation of immunosuppression, but this entails a higher risk of graft loss. Solid organ de novo malignancies are often more aggressive than those in normal population; the life expectancy of these recipients is low.
Veroux
M
M
Department of Surgery, Transplantation and Advanced Technologies, Kidney Transplant Unit, University Hospital of Catania, Catania, Italy. veroux@unict.it
Puliatti
C
C
Fiamingo
P
P
Cappello
D
D
Macarone
M
M
Puliatti
D
D
Vizcarra
D
D
Gagliano
M
M
Veroux
P
P
D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D009369:Neoplasms / Q000453:epidemiology*; D016035:Pancreas Transplantation; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012514:Sarcoma, Kaposi / Q000453:epidemiology; D012878:Skin Neoplasms / Q000453:epidemiology; D013997:Time Factors