SAT-346 POST-TRANSPLANT MALIGNANCY - OUR CENTRE

Abstract

Cancer is now increasingly recognized as a major cause of death among patients especially after kidney transplantation. Malignancy represent a major burden in transplantation medicine. The Incidence is about 12 fold higher for PTLD and 3.5 fold higher for non-cutaneous malignancy compare to age-matched population. The increased risk is multifactorial and attributed to oncogenic viruses, immunosuppression and altered T cell immunity. Aim: We attempted to assess the incidence of post-transplant malignancies in patients who underwent renal transplantation at our centre, along with studying the presentation, type and other factors affecting their development. Materials and methods We analysed data retrospectively from 626 patients who underwent renal transplantation at our centre from January 2003 to September 2018. Pre transplant history, post transplant course including duration on hemodialysis, immunosuppression details and duration till diagnosis of malignancies were collected. Details regarding type of malignancy, histopathology, staging and treatment given and outcome were collected. Number of transplant recipient-626. The total number of patients with malignancy is 12. Incidence of malignancy posttransplant is 1.9%. Male-7 and female-6. One patient was detected with 2 malignancies during her post transplant period. The types of malignancies encountered were Type of Malignancy•Squamous cell Ca of tongue – 3•Post transplant lymphoproliferative disease – 6•Squamous cell carcinoma of lung -1•Adenocarcinoma of pancreas – 1•Carcinoma of colon -1•Atypical papillary neoplasm of breast – 1 ( second malignancy)The mean duration of patient on dialysis before transplantation in the study population was 413 days. The mean duration of interval between diagnosis of malignancy and transplantation was 1560 days. None of these patients had any other risk factors for development of malignancies like exposure to radiation, smoking or family history of malignancies. None of the patients had any past history of malignancies. 3 (30%) out of 10 patients had under-gone deceased related donor transplantation, while the rest had live related renal transplant Conclusion The incidence of malignancy – 1.9%. Probable reason for decreased incidence of malignancy is the decreased immunosuppression needed by South Asian people. The most common malignancy was solid organ tumour; tongue being the most common organ. Most common histological variant is squamous cell carcinoma. Non-Hodgkin is more common than Hodgkin. Incidence of malignancy is low. Decision regarding cancer screening should be made on individual basis.