IMMUNOSUPPRESSION IN RENAL-TRANSPLANTATION DOES NOT INCREASE THE INCIDENCE OF NATIVE RENAL-CANCER

A patient presented with metastatic renal cell cancer arising in a nat ive kidney nine years after undergoing cadaveric renal transplantation . Ten other cases have been detailed in the literature over the past 1 5 years. The risk of renal cancer in hemodialysis patients increases w ith the duration of dialysis and acquisition of cystic disease. The in cidence of renal cell cancers in renal transplant patients and dialysi s patients is equivalent. In both groups of patients the carcinomas ar ise from acquired cysts, but unlike hemodialysis patients, the duratio n of prior hemodialysis in the transplant group does not appear to cor relate with the risk of renal cell carcinoma. Immunosuppression to pre vent graft rejection is associated with a dramatic increase in some ca ncers, but does not appear to be a factor in native renal cancer devel opment. Ultrasound followed by arteriography to diagnose tumors in the subset of patients with cysts could be used for screening of the risk population. The cost of screening though may be prohibitive in diagno sing this rare complication in renal transplant patients.