Long-term graft survival in a kidney transplant recipient with glioblastoma: Case report

Abstract

Long-term immunosuppression after transplantation can increase the risk of cancer development in recipient patients. This case report describes the treatment approach for glioblastoma in a kidney transplant recipient after transplantation. The patient, a 61-year-old woman, received a living donor kidney transplant 24 years ago due to congenital nephrotic syndrome. The patient was on various immunosuppressive medications, including cyclosporine, prednisolone, and mycophenolate mofetil.After 16 years of follow-up, the patient presented with symptoms of brain tumor, leading to further tests. Subsequent examination revealed the presence of a tumor that had spread to frontal region within the brain.A surgical procedure was subsequently conducted to extract the tumor cells and alleviate the resulting pressure within the brain. Based on pathology results, it was determined that the patient had glioblastoma.Methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter was detected, indicating the potential response to chemotherapy. Chemotherapy was initiated, along with radiation therapy.After the diagnosis and surgery, the patient's medications for the kidney transplant were modified. Rapamycin replaced the previous medications, and the dose of mycophenolate mofetil and prednisolone was decreased. After 7 years, the patient's kidney is functioning well, with a creatinine level of 1.5, and brain imaging showed no abnormalities. After kidney transplantation, there is an increased risk of various cancers.Overall, this case report demonstrates a successful treatment approach for glioblastoma after kidney transplantation, emphasizing the need for close monitoring and individualized management in transplant recipients at risk for cancer development.Considering the current stability of the patient's condition after a change in medication regimen, patients who have been using the drug Cyclosporine for a long time should be included in future evaluations due to its carcinogenic properties.