Malignancy after renal transplantation: a single ‐centre experience

Introduction: Malignancy management in renal transplant recipients is becoming a major factor affecting long­ ­term patient survival. Thus, we intended to evaluate both incidence and prognosis of malignant diseases following renal transplantation at a single centre in Portugal. Methods: We studied retrospectively the 2,358 patients who underwent kidney transplantation (KT) between 1983 and 2014. Apart from descriptive analysis, both demographic and clinical characteristics of cancer and non ­cancer cancer patients were compared. Results: During a median follow ­up of 118 (IQR 57 ­179) months, 139 patients (5.8%) developed 158 de novo malignancies, with a median time from KT to diagnosis of 76..5 (IQR 21.0 ­132.0) months. When compared to non ­cancer patients, they were older at KT date, had longer graft survival and a lower living donor recipients’ prevalence. As for post ­transplant malignancies analysis, the most common were non ­cutaneous non ­lymphomatous cancers (49.4%, n=78), skin cancers (35.4%, n=56) and post ­transplant lymphoproliferative disorders (9.5%, n=15). Considering specific diag­ nosis, squamous cell carcinoma and basal cell carcinoma with 17.1% and 16.5% respectively, and non ­Hodgkin lymphomas with 7.6%, were the most frequent. Global mortality among cancer patients was 36.0%, with a median time of 9.7 (IQR 1.9 ­17.5) months from time of diagnosis to death. As for survival analysis, cancer patient survival was significantly lower while censored graft survival was significantly higher in this group. Conclusion: Incidence and characteristics of malignancy following renal transplantation in our unit are similar to those globally described, despite some traits probably a result of specific ethnic and environmental characteristics.