#3551 Posttransplant malignancies in kidney transplant recipients—a single center experience

Abstract Background and Aims Post-transplant malignancy amongst kidney transplant recipients: a single centre 20-year experience and literature review. Method We analysed our data retrospectively which included 794 patients who underwent renal transplantation at our centre between January 2001 to February 2022. Patient's native kidney disease, donor details, duration on hemodialysis, immunosuppression details and duration till diagnosis of malignancies were collected. All details regarding the nature of the malignancy with detailed histopathology, staging, and treatment were also collected. We also did subgroup analysis of multiorgan, liver and hand transplant recipients. Results Of the total 816 cases of renal transplant recipients, 17 recipient (2.08%) were diagnosed with malignancy. Nine out of the 17 patients were males (52%). The mean age at diagnosis was 41 ± 10 years and mean duration of occurrence of malignancy following post transplant was 38 months. Nine patients (52%) developed solid organ tumour and 8 (47%) developed post-transplant lymphoproliferative disease. Of the nine cases of solid organ tumors, 4 had squamous cell carcinoma of the tongue followed by one case each of adenocarcinoma of the pancreas, squamous cell carcinoma of the lung and vulva. 2 patients had carcinoma of the colon, out of which one was post combined liver and kidney transplant. Seven out of 17 patients succumbed to their malignancy, a mortality rate of 41%. Of the eight cases of PTLD, 6 had expired (75%), making PTLD the most fatal post-transplant malignancy in our setting. Of the 794 post-kidney transplant cases reviewed in this single center retrospective study, the incidence of malignancy was 1.8 per 100 population. At our centre, there was a prevalence of PTLD as the major type of post-transplant malignancy, as compared to studies from other centers. PTLD being of poor prognosis, is responsible for a higher post-transplant mortality rate in our population. The most aggressive histopathological variant of PTLD (monomorphous variant) was common in our cohort. This may represent either an ethnic predisposition to this disease or some environmental or immunological risk factors contributing to it occurrence. Conclusion This study points out the need for meticulous surveillance of all post-transplant cases for malignancy considering the associated high rate of mortality.