Bladder carcinoma among live-donor renal transplant recipients: a single-centre experience and a review of the literature.
OBJECTIVE
To present our experience with bladder cancer among a renal transplant population and to review critically the relevant literature.


METHODS
In all, 1865 renal graft recipients were followed for a mean (SD) of 6.5 (5) years. Seven recipients (all men) developed a urothelial bladder tumour. The stage and grade of the tumours were determined. The method of the treatment was selected on the basis of the tumour characteristics and graft function. Patients were regularly followed; the endpoints were cancer-specific survival, recurrence or metastasis.


RESULTS
All patients presented with gross haematuria. There was non-muscle-invasive disease in two patients who were treated by transurethral resection and adjuvant intravesical bacille Calmette-Guérin immunotherapy. One patient died 24 months later due to complications of end-stage renal disease. To date the second patient is alive and free of the recurrence. Five recipients with muscle-invasive disease had a radical cystectomy and orthotopic bladder substitution. The mean (sd) time to the last follow-up or death was 14.6 (3.1) months. Three patients died with stable graft function; two from distant metastasis and one from a cerebrovascular stroke. The remaining two patients are still alive, free of disease and with good graft function.


CONCLUSIONS
Urothelial bladder tumours are generally uncommon. The presence of haematuria in renal allograft recipients should be thoroughly investigated. Early diagnosis and prompt treatment are required for managing such tumours, because they are aggressive. Orthotopic bladder substitution is feasible with a good functional outcome for patients in whom cystectomy is indicated.
Kamal
Mohamed M
MM
Department of Urology, Urology and Nephrology Center, Mansoura, Egypt.
Soliman
Shady M
SM
Shokeir
Ahmed A
AA
Abol-Enein
Hassan
H
Ghoneim
Mohamed A
MA
D000328:Adult; D015331:Cohort Studies; D015653:Cystectomy / Q000379:methods*; D042241:Early Diagnosis; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012307:Risk Factors; D016019:Survival Analysis; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion