期刊
AMERICAN JOURNAL OF KIDNEY DISEASES
卷 39, 期 1, 页码 -出版社
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/ajkd.2002.29926
关键词
renal transplantation; malignancy; immunosuppression; skin cancer; renal cell carcinoma; post-transplantation lymphoproliferative disease (PTLD)
Malignancy following renal transplantation is an important medical problem during the long-term follow-up. The overall incidence of malignancy at this time is 3 to 5 times higher than in the general population. The most common malignancies are lymphoproliferative disorders (early after transplantation) and skin carcinomas (late after transplantation). The type of malignancy is different in various countries and dependent on genetic and environmental factors. Another important confounder for risk of malignancy after renal transplantation Is the type of immunosuppression. Previous use of cytotoxic drugs (eg, cyclophosphamide) or a history of analgesic abuse are additional risk factors. Malignancy may even be transplanted by the graft. Previous cancer treatment in a uremic patient on the transplant waiting list is of great importance in relation to waiting time and postmalignancy screening. Finally, every dialysis patient on the waiting list should undergo a regular screening program before and after renal transplantation to detect a potentially malignant tumor In an early stage. In addition to specific oncological treatment, managing a malignancy after renal transplantation should Include modification of immunosuppression. (C) 2002 by the National Kidney Foundation, Inc.
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