Forty years of kidney transplantation: Insights into malignancies at a single center in Latin America.

BACKGROUND

Kidney transplantation is the optimal therapy for end-stage kidney disease (ESKD), but lifelong immunosuppression increases malignancy risk, a major cause of mortality in transplant recipients. This study evaluates post-transplant malignancies in a kidney transplant cohort.

METHODS

We conducted a retrospective analysis of 375 kidney transplant recipients at Hospital Las Higueras, Talcahuano (January 1981-July 2024). Demographics, clinical characteristics, and malignancy data were extracted from medical records.

RESULTS

Of 375 patients, 33 (8.8 %) developed malignancies, with 27 % experiencing multiple cancers. While the mean age at transplantation was 51.5 years, the mean age of those developing a malignancy was 60.4 years. Non-melanoma skin cancers were most common (55.1 %), followed by solid organ cancers (26.5 %), chronic kidney disease (CKD)-related cancers (8.2 %), and hematologic malignancies (8.2 %). The mean time to malignancy onset was 106 months post-transplant. Cancer-related mortality was 30 %.

CONCLUSION

The high incidence of malignancies, particularly skin cancers, highlights the need for regular clinical and dermatologic surveillance in transplant recipients. Optimizing immunosuppression to balance rejection prevention and cancer risk, along with comprehensive cancer screening, is essential for improving long-term outcomes.