Management of the kidney transplant patient with Cancer: Report from a Multidisciplinary Consensus Conference

Romagnoli, Jacopo; Tagliaferri, Luca; Acampora, Anna; Bianchi, Valentina; D’Ambrosio, Viola; D’Aviero, Andrea; Esposito, I.; Hohaus, Stefan; Iezzi, Roberto; Lancellotta, Valentina; Maiolo, Elena; Maiorano, Brigida Anna; Paoletti, Filippo; Peris, Ketty; Posa, Alessandro; Preziosi, Francesco; Rossi, Ernesto; Saglio, Giuseppe; Schinzari, Giovanni; Spagnoletti, Gionata; Tanzilli, Alessandro; Scambia, Giovanni; Valentini, Vincenzo; Maggiore, Umberto; Grandaliano, Giuseppe

doi:10.1016/j.trre.2021.100636

Cited by 5 publications

(4 citation statements)

References 95 publications

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“…We know that KT recipients are at increased risk of recurrence for certain types of cancer, especially Kaposi sarcoma, nonmelanoma skin cancers, and posttransplant lymphoproliferative disorders. The increased risk in those cancers can be attributed to several factors, amongst which immunosuppression and viral infections play an important role [ 7 ]. Management of cancer recurrence or de novo cancer in KT patients is a challenging task.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Transplant Suitability in a Patient with Previous Colorectal Cancer and Subsequent Radiation Cystitis: Insights from a Complicated Case

Dogahe,

Cubilier,

Taghavi

et al. 2023

Case Reports in Nephrology

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Assessing transplant suitability can be a meticulous process, involving multiple investigations and various specialties. This process is well described in the latest KDIGO guidelines. We recently asked ourselves if those guidelines are still relevant to current clinical practice given the rapid evolution of modern medicine, especially in the field of oncology. We present the complicated case of a 60-year-old woman with ESKD (end-stage kidney disease) and a prior history of cancer, with secondary urological complications, to illustrate different interesting considerations for KT (kidney transplant). Our patient was diagnosed with rectal cancer at the age of 46, for which she was treated with surgery and radiotherapy before developing chronic radiation cystitis. This was followed by repeated urinary tract infections and secondary nephrolithiasis, ultimately leading to severe bilateral hydronephrosis and obstructive ESKD. We know that the type of cancer and its characteristics should be evaluated in detail, and we should offer patient-tailored recommendations after a multidisciplinary evaluation. In our case, the prior rectal cancer is not to be feared because curative treatment has been achieved and the patient has been cancer-free for 14 years, knowing that this type of cancer is not at high risk of recurrence after transplantation. The frail urological anatomy, however, represents a bigger challenge. Not only does it complicate the technical feasibility of KT but it also increases the risk of complications and graft failure. It is difficult to clearly determine KT possibility when considering it in such patients. What is clear on the other hand is that such a decision should be taken considering the choice of the patient and the involved physicians. We should also consider the potential benefits and risks of KT in order to make an informed decision.

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Section: Discussionmentioning

confidence: 99%

“…Management of cancer recurrence or de novo cancer in KT patients is a challenging task. Experts consensus exists on this topic [ 7 ] but there is once again a lack of good-quality evidence to support the creation of reliable guidelines on this subject.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Transplant Suitability in a Patient with Previous Colorectal Cancer and Subsequent Radiation Cystitis: Insights from a Complicated Case

Dogahe,

Cubilier,

Taghavi

et al. 2023

Case Reports in Nephrology

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“…Unfortunately, in RCC patients who had undergone renal transplantation for ESKD, the use of ICIs has a negative impact on graft survival by increasing the potential for rejection. Although ICIs represent a serious risk for KTRs, other systemic therapies, such as anti-angiogenic drugs, hormone therapy, and platinum salts, are widely considered to be safer options for KTRs, although potentially less effective [ 87 ]. Providers should be mindful when administering anti-angiogenic drugs to treat RCC in ESKD patients as proteinuria, nephrotic syndrome, and diarrhea, all of which are common adverse effects, may worsen their already impaired renal function [ 88 , 89 , 90 ].…”

Section: Treatment Modalities For Rcc In Eskd Patientsmentioning

confidence: 99%

“…The addition of mTOR inhibitors to help negate cancer progression in KTRs may be promising in terms of overall patient survival, although specific outcomes for complex RCC are still unknown [ 91 , 92 , 93 ]. Use of mTOR inhibitors in KTRs must be carefully monitored as they have been linked to impaired wound healing and thus should not be administered prior to oncologic surgical intervention for RCC, or prior to transplantation itself [ 87 , 94 ]. Nephron-sparing surgery remains a viable and effective treatment option for well-localized RCC in the graft kidney.…”

Section: Treatment Modalities For Rcc In Eskd Patientsmentioning

confidence: 99%

Renal Cell Carcinoma in End-Stage Kidney Disease and the Role of Transplantation

Robinson,

Nag,

Peticca

et al. 2023

Cancers

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Kidney transplant patients have a higher risk of renal cell carcinoma (RCC) compared to non-transplanted end-stage kidney disease (ESKD) patients. This increased risk has largely been associated with the use of immunosuppression; however, recent genetic research highlights the significance of tissue specificity in cancer driver genes. The implication of tissue specificity becomes more obscure when addressing transplant patients, as two distinct metabolic environments are present within one individual. The oncogenic potential of donor renal tissue is largely unknown but assumed to pose minimal risk to the kidney transplant recipient (KTR). Our review challenges this notion by examining how donor and recipient microenvironments impact a transplant recipient’s associated risk of renal cell carcinoma. In doing so, we attempt to encapsulate how ESKD-RCC and KTR-RCC differ in their incidence, pathogenesis, outcome, and approach to management.

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Efficacy and safety of MWA versus RFA and CA for renal tumors: A systematic review and meta-analysis of comparison studies

Castellana¹,

Natrella²,

Fanelli³

et al. 2023

European Journal of Radiology

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Management of the kidney transplant patient with Cancer: Report from a Multidisciplinary Consensus Conference

Cited by 5 publications

References 95 publications

Evaluation of Transplant Suitability in a Patient with Previous Colorectal Cancer and Subsequent Radiation Cystitis: Insights from a Complicated Case

Evaluation of Transplant Suitability in a Patient with Previous Colorectal Cancer and Subsequent Radiation Cystitis: Insights from a Complicated Case

Renal Cell Carcinoma in End-Stage Kidney Disease and the Role of Transplantation

Efficacy and safety of MWA versus RFA and CA for renal tumors: A systematic review and meta-analysis of comparison studies

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