|IMMUNOSUPPRESSION IN RENAL-TRANSPLANTATION DOES NOT INCREASE THE INCIDENCE OF NATIVE RENAL-CANCER|
Authors: ST PIERCE, MA DOUKAS, T WAID
Affiliations: UNIV KENTUCKY,MED CTR,DIV TRANSPLANT NEUROL,LEXINGTON,KY 40536.
A patient presented with metastatic renal cell cancer arising in a native kidney nine years after undergoing cadaveric renal transplantation. Ten other cases have been detailed in the literature over the past 15 years. The risk of renal cancer in hemodialysis patients increases with the duration of dialysis and acquisition of cystic disease. The incidence of renal cell cancers in renal transplant patients and dialysis patients is equivalent. In both groups of patients the carcinomas arise from acquired cysts, but unlike hemodialysis patients, the duration of prior hemodialysis in the transplant group does not appear to correlate with the risk of renal cell carcinoma. Immunosuppression to prevent graft rejection is associated with a dramatic increase in some cancers, but does not appear to be a factor in native renal cancer development. Ultrasound followed by arteriography to diagnose tumors in the subset of patients with cysts could be used for screening of the risk population. The cost of screening though may be prohibitive in diagnosing this rare complication in renal transplant patients.