Post-transplant malignancy (PTM) has been well established complication of kidney transplantation, but the reported data was mainly from Caucasian population. This study was conducted to determine the incidence and mortality rate of PTM in Praram 9 Hospital.
We retrospectively retrieved medical data of 858 patients who underwent kidney transplantation at our center over the past 27 years.
There were 57 of 858 (6.6%) patients developed malignancy. The most common site of PTM was genitourinary tract cancer (26 of 57, 45.6%), of which transitional cell carcinoma (TCC) was represented in the highest range (20/26, 79.2%), followed by renal cell carcinoma (RCC, 4/26) and prostate cancer (2/26). The second and third most common PTM were hepatocellular carcinoma (HCC, 9 of 57, 15.5%) and colon cancer (5 of 57, 8.6%), respectively. Lung cancer, post transplantation lymphoproliferative disease were also found (n = 4, each). Other malignancies were as followed: skin cancer (3), breast cancer (3), pancreatic cancer (1), thyroid cancer (1), parotid gland cancer (1) and gastrointestinal stromal tumor (1). The overall mortality rate of PTM was 64.91%. Among 20 patients with TCC, up to 8 patients died from this cancer (mortality rate 40%). Albeit, the mortality rate was zero in skin cancer and RCC of both native and transplanted kidney.
Transitional cell carcinoma was not only the most common PTM in contrast to the Caucasian data, but it also caused the high mortality rate among Thai kidney transplant patients. Our study suggests that a more aggressive surveillance for TCC is required in both pre and post kidney transplant recipients for the early detection and treatment of this cancer. This surveillance should be expanded to the other Asian population in other countries.
Suthanit Laowalert.
Has not received any funding.
All authors have declared no conflicts of interest.