Characteristics and Graft Survival of Kidney Transplant Recipients with Renal Cell Carcinoma

Abstract

Background: The incidence of renal cell carcinoma (RCC) is higher in kidney transplant recipients (KTRs) compared to the general population. However, the risk factors and outcomes based on the diagnosis of RCC after kidney transplantation are limited. Methods: We analyzed risk factors for the development of RCC in KTRs transplanted at our institution between 1994 and 2016. We compared the incidence of graft failure and mortality in KTRs with RCC to matched controls using 5:1 event density sampling. Identifying the risk factors of RCC and patient and graft survival were outcomes of interest. Results: There were 4,178 KTRs performed at our institution during the study period, and 51 patients were diagnosed with RCC. Recipients were followed until graft failure or death. We did not identify commonly looked at baseline characteristics associated with the risk of RCC. Comparing KTRs with RCC to matched controls, RCC patients were younger (47.5 vs. 49.6 years, p < 0.01), received basiliximab induction more commonly (p = 0.01), had hypertension and glomerulonephritis as causes of end-stage renal disease (p = 0.01), and were more likely to be smokers (p < 0.01). RCC was significantly associated with death-censored graft failure (adjusted hazard ratio [HR]: 1.76; 95% CI: 1.02–3.03; p = 0.04) but not patient death (adjusted HR: 0.95; 95% CI: 0.50–1.83; p = 0.89). Conclusion: In our experience, RCC had a detrimental impact on graft survival among KTRs, highlighting the potential benefit of early diagnosis and optimal immunosuppression management in optimizing graft survival.

Metastatic Translocated Renal Cell Carcinoma in a Kidney Transplant Patient - a Case Report and Review of the Literature

“…In general, transplant recipients have an increased risk of malignancies including a 6- to 15-fold increased risk of different subtypes of renal cell carcinomas. 6 - 8 Most of the tumours occur in the remaining native kidney and only about 10%-20% originate from the kidney transplant. 7 , 9 Despite the close association between acquired cystic disease-associated renal cell carcinomas and end-stage renal disease, the most common renal cell carcinoma subtypes in transplant recipients are clear cell and papillary renal cell carcinomas.…”

“… 6 - 8 Most of the tumours occur in the remaining native kidney and only about 10%-20% originate from the kidney transplant. 7 , 9 Despite the close association between acquired cystic disease-associated renal cell carcinomas and end-stage renal disease, the most common renal cell carcinoma subtypes in transplant recipients are clear cell and papillary renal cell carcinomas. 7 , 9 Most of the renal cell carcinomas arising in kidney transplant recipients are limited to the kidney irrespective whether they arise in the native or the transplanted kidney.…”

“… 7 , 9 Despite the close association between acquired cystic disease-associated renal cell carcinomas and end-stage renal disease, the most common renal cell carcinoma subtypes in transplant recipients are clear cell and papillary renal cell carcinomas. 7 , 9 Most of the renal cell carcinomas arising in kidney transplant recipients are limited to the kidney irrespective whether they arise in the native or the transplanted kidney. 9 - 11 However, some examples with distant metastasis are reported but none of them into the renal allograft.…”

Kidney Allograft Fibrosis: Diagnostic and Therapeutic Strategies

“…20 Although risk of death declined over the past 20 y in transplant patients, still many die from cardiovascular diseases and infections early after transplantation, and from cancer and cardiovascular diseases at later time points. 21,22 Therefore, death remains an important cause of allograft failure. 23 In this review, we will focus on key pathways, diagnosis, and therapeutic options in kidney allograft fibrosis.…”