MALIGNANT NEOPLASMS IN RENAL-ALLOGRAFT RE CIPIENTS - RESULTS OF A YEARLY SCREENING-PROGRAM BY ABDOMINAL ULTRASOUND AND CHEST-X-RAY

Purpose: To evaluate the prevalence of malignant neoplasms after renal transplantation by means of a radiological screening programme and to determine the role of some clinical and demographic parameters concer ning pathogenesis of these malignancies. Material and methods: Between November 1992 and June 1994 in a prospective study 504 consecutive re nal allograft recipients (331 m, 173 f) aged 51 +/- 13 years underwent routine abdominal ultrasound examinations including the renal transpl ant and p. a. and lateral chest x-rays once a year. Results: This scre ening programme revealed 11 malignant neoplasms in 11 patients (2.2%). We detected 6 renal cell carcinomas (RCC) in the patient's native kid neys, two RCCs in two renal allografts, two non-Hodgkin-lymphomas in t he liver and the renal allograft, respectively, and one ovarial carcin oma. Patients with renal cell carcinomas in the native kidneys were si gnificantly older than allograft recipients without tumors. The presen ce of acquired cystic kidney disease (ACKD) seems to be an additional risk for the development of RCC. There were no significant differences in the time on dialysis, the time with functional renal allograft, an d the immunosuppressive therapy. Conclusion: Yearly abdominal ultrasou nd screening including the renal allograft; is a valuable tool for the early detection of neoplasms in asymptomatic renal allograft recipien ts. However, routine yearly chest x-rays should not be performed in re nal allograft recipients without preexisting tumours.