Malignancy and Kidney Transplant: Core Curriculum 2026.

Kidney transplant recipients are at least twice as likely to develop cancer compared with immunocompetent people. Cancer is now the second leading cause of death in kidney transplant recipients. Candidates and recipients are living longer with chronic conditions and immunosuppression, which increases the risk of cancers, especially skin and kidney cancers, lymphoma, and plasma cell dyscrasias. Given the complexities associated with the care of transplant patients with cancer, along with the advent of novel cancer therapies that include targeted and immunotherapies (ie, immune checkpoint inhibitors and CAR-T cells), there is a growing need for nephrologists to understand and manage the associated risks and optimize diagnosis and treatment. The screening and management of cancer in the setting of kidney transplantation is best accomplished by a multidisciplinary team, involving knowledgeable nephrologists, oncologists, and patients. In this Core Curriculum, we review common pretransplant and posttransplant cancers and management strategies through a series of clinical cases.