De novo cancer occurrence after renal transplantation: A medical center experience in Taiwan

Renal transplantation has been advocated as the treatment of choice for end-stage renal disease. Organ transplantation increases the incidence of cancer through unclear mechanisms. A literature review showed that the most common neoplasms are of skin origin, which are uncommon in Eastern people. We reviewed cancer patterns in our renal transplant series. From July 1981 to December 2002, among 560 renal transplantations performed in this hospital, we retrospectively surveyed cancer incidence, types, and usage of immunosuppressants. Twenty nine cancer cases 5.18% (incidence) included hepatocellular carcinoma (HCC) as the highest mortality rate (9 of 13 cases). Eight of these 13 cases were hepatitis B carriers. All four hepatitis C carriers expired three of them with unresectable multinodular tumors at diagnosis in Posttransplantation lymphoproliferative disorder (PTLD) was the second most common cancer (seven cases); all but one survived with reduced doses of or changes in immunosuppressants. No skin cancer other than four Kaposi's sarcomas with skin manifestations was detected in our series. HCC was the main cancer in our series. Accepting hepatitis B carriers as candidates for renal recipients and donors may be one of the causes. PTLD was the second most common cancer, while there were no skin cancers.