Cancer after renal transplantation.
OBJECTIVE
Prolonged waiting times for renal transplantation, an increase in the average age of recipients, decreased acute rejection rates due to use of newer potent immunosuppressives and improving long-term transplant survival have raised concerns in the transplant community regarding posttransplant cancer. In view of the fact that transplant recipients are living longer, it is of paramount importance that we continue to translate discoveries at the bench to the bedside and document cancers in the posttransplant recipient registries. Analysis of data will help in optimizing patient management.


RESULTS
Recent evidence indicates that sirolimus is associated with a decreased incidence of posttransplant de-novo cancer and remission of Kaposi's sarcoma and nonmelanoma skin cancer. Mycophenolate mofetil has been shown to have an antiproliferative activity against leukemia and lymphoma and an anti-tumor effect against colon and prostate cancer. Clinically it has been shown to be associated with a reduced incidence of cancers like posttransplant lymphoproliferative disorder.


CONCLUSIONS
Appropriate selection of transplant candidates, pretransplant and posttransplant cancer surveillance and judicious evidence-based use of newer immunosuppressants may help reduce the incidence and improve the outcome of posttransplant cancer.
Vasudev
Brahm
B
Division of Nephrology, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
Hariharan
Sundaram
S
D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives; D009369:Neoplasms / Q000209:etiology* / Q000517:prevention & control*; D011159:Population Surveillance; D020123:Sirolimus
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D020123:Sirolimus