Elsevier

Transplantation Proceedings

Volume 49, Issue 8, October 2017, Pages 1779-1782
Transplantation Proceedings

New Approaches in Transplantation
Kidney transplantation
Renal Cell Carcinoma in Renal Transplantation: The Case for Surveillance

https://doi.org/10.1016/j.transproceed.2017.06.031Get rights and content

Highlights

  • Malignancy post-renal transplant is a common cause of death.

  • Early detection and treatment of renal cell carcinoma a through routine screenings of kidney transplant recipients is best practice.

  • Ultrasound is a simple, convenient test to diagnose and prevent development of advanced stage cancer.

Abstract

Introduction

Between January 2013 and September 2015, 135 consecutive renal transplant patients were screened prospectively with ultrasound for renal cell carcinoma (RCC).

Results

Eighteen ultrasound abnormalities were identified with 4 solid lesions detected. Fifty-six other patients were screened retrospectively by referring nephrology groups, with 6 additional malignancies found.

Conclusion

As a result of our data, we recommend and have instituted annual ultrasound screening of native kidneys in all renal transplant patients.

Section snippets

Patients and Methods

Beginning on January 1, 2013, 135 prospective retroperitoneal ultrasounds were performed on all new kidney transplant recipients at 6 months and 1 year postoperatively during routine appointments. The ultrasounds were interpreted by a group of 3 radiologists unfamiliar with the clinical course of the patient to maintain objectivity. Patients with ACD, defined as 4 or more cysts in native kidneys, continued with ultrasound screening every 6 months. During this period, we also retrospectively

Results

Patient characteristics are shown in Table 1 for the prospectively screened group (n = 135). Table 2 shows that 18 ultrasounds (13.3%) were identified as abnormal: 14 of the 135 (10.4%) were defined as ACD and 4 (2.9%) solid lesions were detected. Three of the solid lesions were subsequently histologically confirmed as RCC, and one was a benign inflammatory mass in a patient with prior pretransplant RCC.

Fifty-six other ultrasounds were reviewed retrospectively; results were reported to us by

Discussion

Malignancy post-renal transplant is a common cause of death. We argue that early detection and treatment of RCC through routine screenings of kidney transplant recipients is best practice. Ultrasound is a simple, convenient test to diagnose and prevent development of advanced-stage cancer, which has an unfavorable prognosis [4]. In a large, retrospective study of the Medicare population on hemodialysis, the relative risk of malignancy was most elevated for cancers in the kidney, ureter, and

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