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One of the complications of kidney transplantation, perhaps the most feared and most likely linked to immunosuppression, is the appearance of cases of neoplasia in the course of the post-medial kidney transplant course In the literature, population studies are mentioned with descriptions of the risk of acquiring neoplasms in patients with kidney transplantation, the type of hematological, dermatological and solid tumor neoplasms, the time of onset, and this association with immunosuppressants is always sought
In this study, we analyzed from a clinical-epidemiological point of view a series of cases of patients from the Kidney Transplant Unit of the Nephrology Service of the HCIPS
Objective General: To determine the most common types of neoplasm in our population of kidney transplant recipients at HCIPS
Specific: to determine the clinical and epidemiological characteristics of these cases with neoplasia
Material and Method
Design: Retrospective descriptive observational cross-sectional study with an analytical component Non-probability sampling, consecutive cases Cases of neoplasms were studied in adult transplant patients with a living or cadaveric donor from the registry of the HCIPS Kidney Transplant Unit
Qualitative Variables: Sex, Types of Neoplasm, Types of Immunosuppressants, Rotation to Sirolimus, Deaths.
Quantitative variables: Age, Years between transplantation and diagnosis of neoplasm, creatinine, GFR, Proteinuria.
Data analysis with Office Excel, descriptive statistics, and correlations between variables
Number of Cases N 19 kidney transplant patients with neoplasms in a period between 1986 and 2019, out of a total of 234 transplanted patients, it should be noted that azathioprine was used until 2011 and cyclosporine until 2014 Sex; M 8 cases 42%; F 11 cases 58%, Age; mean 55.05 years SD 12.35 years between transplantation and diagnosis of the neoplasm; 11.47 years SD7.02, Types of Neoplasms; Basal cell Ca 9; 47%, Lymphoma 3:16%, Cervical Ca 3; 16%, Melanoma 2; 11%, Ca bladder 1 ; 5%, Myeloma 1; 5% Type of immunosuppressants before the diagnosis of neoplasia: azathioprine 5: 26% and mycophenolate mofetil 14; 74% and among the CNI cyclosporine 8; 42% and tacrolimus 11; 58%, rotation to Sirolimus after cancer diagnosis in 12 cases; 63%, with good evolution of renal function; in 7 cases; 27% could not be rotated to Sirolimus 3 due to proteinuria, 2 due to drug intolerance, 1 with relapsed GNFS and 1 with chemotherapy, Renal function with Sirolimus; Mean creatinine 1.10 SD 0.48 g/dl; Mean GFR 80.9 SD 30.2 ml min and Proteinuria 713 SD 1258 mg in 24 HS Current renal function of the 19 cases; 1 entered dialysis, the remaining 18 cases with mean creatinine 1.05 mg/dl SD 0.40; Mean GFR 75.14 SD 27.05 ml/min, Mean proteinuria 644.94 SD 1022.68 mg/24 hs; Deaths; 3 cases, with a mean age of 47.5 years SD 20, 2/3 were already with pulmonary and abdominal MTX and in all 3 cases with good renal function Correlations: Age and occurrence of neoplasms: less than 50 years 5 cases; 26% and over 50 years 14 cases; 74%; t student p: 0.00012631; Years elapsed between kidney transplantation and diagnosis of the neoplasm: less than 10 years 7 cases; 17% and more than 10 years 12 cases; 63% t student p: 0.0006249915 Prevalence of types of neoplasms; Dermatological 58%, Hematological 21%, Solid tumors 21%
1 The most common types of neoplasms after kidney transplantation are; Dermatological 58%, Hematological 21%, Solid tumors 21%
2 Neoplasms appear more frequently, in 74%, in patients over 50 years of age
3 They tend to appear more frequently, in 63% of cases, after 10 years of kidney transplantation
4 Sirolimus proved to be a good immunosuppressant in these cases, maintaining good renal graft function
5 There were 3 deaths, 2 of them with poor evolution and with mtx., with good function of the renal graft