Renal Cell Carcinoma of Native Kidneys in Kidney Allograft Recipients: Are There Any Guidelines for Management?

Background

Renal cell carcinoma (RCC) accounts for nearly 90% of kidney cancers. Transplantation is the best treatment for kidney failure, associated with improved survival, quality of life, and lower societal costs compared with remaining on dialysis. Thanks to modern immunosuppression, rejection rates have decreased. Cancer is the second most common cause of morbidity and mortality in kidney transplant recipients (KTRs) after cardiovascular disease. KTRs are at increased cancer risk due to chronic immunosuppression. Case report: We report a 54-year-old kidney transplant recipient without prior history of malignancy who developed metachronous bilateral RCC early posttransplant (first RCC within 3 months after kidney transplantation and second RCC after one year later). Both tumours were treated with nephrectomy.

Conclusions

Early diagnosis enabled appropriate oncologic management while preserving graft function. It should also be stressed that beside graft assessment, abdominal sonography should not be forgotten in kidney allograft recipients, in particular, in certain high-risk patients (i.e., elderly, male, with longer dialysis vintage, smokers, obese, with high burden of immunosuppression including pretransplant immunosuppressive therapy, induction at transplantation, etc.).