Malignancy following renal transplantation.

After transplantation, there is an increase in the incidence of a wide variety of malignancies compared to the general population, due to the chronic use of immunosuppressive agents. They appear to have a more aggressive behavior and a worse outcome. As a result, among recipients of renal transplantation, malignancy is the third most common cause of patient death with graft function, after cardiovascular diseases and infections. Since management and outcomes of the cardiovascular and infectious complications are improving, malignancy after transplantation will probably become more important (Briggs, 2001). In this chapter, we will focus on the increased cancer incidence in solid organ transplant recipients, in order to emphasize the clinical importance of this topic in renal transplant patients. Since skin cancer and post-transplantation lymphoproliferative disorder PTLD are most strikingly increased after renal transplantation, we will study them in detail. There is some evidence that individual immunosuppressive agents have a different role in the development of post-transplantation malignancy. The available data on this will be discussed. Finally, based on the currently available international guidelines, we will propose an appropriate prevention and early detection program for patients undergoing renal transplantation.