Tumors in Native Kidney and Renal Grafts After Renal Transplantation. Experience of Our Centre

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Abstract

Introduction

Kidney transplantation is the best treatment for terminal chronic kidney disease. The development of cancer has been considered the most common long-term complication of immunosuppressive therapy. No greater incidence of renal cancer has been observed in general transplanted patients (3%), but there is a greater incidence among kidney transplant patients.

Introduction

Tumor on the graft is very rare (0.5%). The objective of the present study is to analyze the development of renal tumors on native kidney and renal graft in our population.

Material and Methods

Between November 1979 and December 2016 we hace performed 1,729 kidney transplants. We have analyzed data regarding recipient and donor. The histological result, time of appearance or treatment, was collected from our database.

Results

We have reported 26 cases (1.5%), 19 on native kidneys (1%) and 7 on kidney graft (0.4%). The average age of the recipients was 47.4 years (18-79.5), 49.7 (35.2-79.5) among the patients who developed cancer on the native kidney and 42.7 (18.5-58.4). ) among those who developed it on the graft.

Results

There were 10 women, 7 among the patients with tumor on native kidney (36.8%) and 3 among the tumors of the graft (42.8%). The average age of the donor was 48.6 years in the total group (5-86), being 45.1 (5-86) among the donors of the patients with tumor on native kidney and 56.6 (41-79) in the rest. 17 tumors were clear cell renal adenocarcinoma (15 in native kidney and 2 in graft), 1 adenoma and oncocytoma in native kidney, 2 high-grade papillary urothelial carcinomas in native kidney and 5 on graft (p <0.05), and 1 tumor mixed solid papillary / clear cells in native kidney. The average time of onset was 2,918.8 days (8 years) among all cancers detected, being 3,017.7 (8.3 years) in the patients with native kidney and 2,650.3 (7.3 years) in the graft. The treatment in the native kidney group consisted of nephrectomies except for 2 tumorectomies, as well as among the graft neoplasms, which were treated with a transplantectomy except for a partial nephrectomy.

Conclusions

Cancer on native kidney and renal graft are infrequent and appear after several years after transplant date. The histological type papillary urothelial carcinoma has an increased incidence in relation to the general population, and significantly on the renal graft. The treatment is surgical and in the majority of cases it was associated with a transplant in our patients.

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