Journal List > J Korean Soc Transplant > v.23(2) > 1034282

Kong: Malignancy in Renal Transplant Recipients


With improved management of infectious and cardiovascular complications of renal transplant recipients, prolonged survival with long-term follow up duration, and increasing age of patients, cancer became an increasingly important cause of morbid-ity and mortality in transplant patients. Literatures indicate three to fivefold incidence of malignancy in solid organ transplant recipients compared with that of general population. Certain types of malignancy, such as skin cancer, Kaposi's sarcoma, lymphoma, cervical, oral and anogenital cancer, hepatocelluar and renal cell carcinoma are particularly reported to be high in incidence. Reduction of immunosuppressive medication is the first step to be considered for the management, especially for virus-associated cancer. The inhibitor of mammalian target of rapamycin(mTORi) suppresses the growth and proliferation of tumors in various animal models, cured Kaposi's sarcoma and seems to reduce the incidence of de novo malignancies of renal transplant recipients, and is therefore a valuable option for the management of cancer of these patients without increment of the risk of graft rejection.


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Table 1.
Guidelines for cancer screening in the general population recommended by the National Cancer Information Center, Korea, and U.S. and European guidelines for transplant population
  Screening program for 5 major cancers, by the National Cancer Information Center, Korea(29) U.S. and European guidelines for transplant patients(30,31)
Stomach Biennial barium radiography or gastroscopy for individuals older than 40 years None
Liver Abdominal USG and AFP every 6 months for those with liver cirrhosis, HBsAg(+) or anti-HCV(+) No firm recommendation, but abdominal USG and AFP every 6 months in high risk recipients
Colon Annual FOBT for individuals older than 50 years, If FOBT(+), then barium enema or colonoscopy Annual FOBT and/or 5-yearly flexible sigmoidoscopy for those older than 50 years
Breast Monthly self-exam for women older than 30 years, biennial mammography+ exam by physician for women older than 40 years Annual or biennial mammography for women older than 50 years
Cervix Biennial cytological screening for women older than 30 years Annual cytological screening and pelvic exam once sexually active
Prostate   Annual DRE and PSA measurement in men older than 50 years
Skin   Monthly self-skin exam, total body skin exam every 6∼12 months by expert physician or dermatologist
Renal tract   No firm recommendation, some suggested regular USG of the native kidneys

Abbreviations: USG, ultrasonography; AFP, alpha-feto protein; FOBT, fecal occult blood test; DRE, digital rectal examination; PSA, prostate specific antigen.

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