POS-710 KIDNEY TRANSPLANT RECIPIENTS WITH A PRETRANSPLANTATION CANCER HISTORY

Abstract

Pretransplant malignancy (PTM) in remission has long been considered a relative contraindication for organ transplantation due to the heightened risk of cancer recurrence associated with immunosuppression used after transplantation. In recent years, older patients are being accepted for transplantation. The purpose of this study was to investigate overall and cause-specific mortality in kidney transplant patients with a history of malignancy, to evaluate overall survival and cancer-related outcomes. We conducted a retrospective descriptive study collecting all cases of kidney transplanted patient with cancer history in the nephrology department over a period of forty years A total of three patients with cancer history underwent a kidney transplantation Case 1. A 56-year-old man underwent kidney transplantation because of bilateral nephrectomy. Right nephrectomy indicated in front of non-functional lithiasis kidney and a left nephrectomy indicated in front of vesical tumor invasion. Sixteen years before the transplant he was diagnosed as having a vesical tumor GII PT1. During his nine years of follow up he has had an episode of urinary infection, an episode of rejection and an episode of endocarditis. There has been no recurrence of malignancy. Case 2. A 45-year-old women underwent kidney transplantation because of vascular nephropathy. Two years before the transplant she underwent a thyroidectomy as treatment of papillary thyroid carcinoma and since then he has been considered cured. During her three years of follow up she has had an episode of rejection, an episode of urinary infection, a serous cystadenoma after one year of transplantation indicated the switch by sirolimus and cortico-induced diabetes. There has been no recurrence of malignancy. Case 3. A 65-year-old women underwent kidney transplantation because of chronic glomerular nephropathy. Eleven years before the transplant she underwent a radical mastectomy followed by hormonal therapy as treatment for breast cancer. During her five years of follow up she has had many episode of urinary infection, cortico-induced diabetes and an episode of ischemic cerebrovascular accident. There has been no recurrence of malignancy. Our findings indicate that there is no significant morbidity from recurrence cancer and no development of secondary type of cancers in pre-existing malignancies. But we must be careful about risk of rejection. The factors that should be considered in each individual case are the type and extent of cancer and the duration between diagnosis and the proposed transplant.