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The incidence of urothelial carcinoma (UC; formerly transitional cell carcinoma) is higher among renal transplant recipients compared with the general population. Upper urinary tract UC (UUT-UC) of allograft urothelium is a rare event with approximately 40 cases reported in the literature. Herein, we describe the clinical presentation and management of UUT-UC in a transplant ureter 10 years after deceased donor kidney transplantation.

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risk of recurrence of RCC of native kidneys and death in patients with end-stage renal disease (ESRD), according to their dialysis or transplantation status.METHODS: We performed a retrospective analysis of all patients with ESRD diagnosed with RCC between 2010 and 2019 in our center, and stratified them according to their dialysis (D) or kidney transplantation (KT) status.Patients' characteristics were compared by using Chi-square (or Fischer) and t-tests. Survival was assessed by Kaplan-Meier and Cox proportional hazards model. RESULTS: 40 patients were followed for a median of 41 months [IQR 22-71], 22 KT and 18 D. KT had a lower ASA score (p<0.001) and lower grade of tumor (p[0.014). All other clinical and pathological characteristics were similar between groups. The risk of RCC recurrence was similar between them (HR[0.402; p[0.458). 5-year recurrence-free survival was 96% in KT and 89% in D (p[0.443). All recurrences were on the contralateral kidney, without impact on patient or graft survival. In multivariable Cox regression analysis, no predictor was significantly associated with the risk of recurrence, including presence of KT. No cancer-related deaths were seen during follow-up, with the majority of deaths being related to cardiovascular disease (100% in KT and 60% in D). 5-year overall survival was 91% and 72% for KT and D, respectively (p[0.181). KT did not have a lower survival compared to D patients (HR[0.343; p[0.202). In multivariable analysis the presence of a renal transplant had no effect on survival (HR[0.002; p[0.167). Time on dialysis was the only independent predictor of overall survival (HR[1.058; p[0.049).CONCLUSIONS: Most RCCs in renal transplant recipients are low-grade and exhibit many favorable pathological characteristics. Immunosuppression doesn't seem to have an impact on outcomes, but an increased time on dialysis seems to be associated with worse survival. As so, waiting time for low stage/low grade RCC could be reduced.

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