Renal cortical neoplasms in long term survivors of solid organ transplantation

Background, Renal cortical neoplasms have been reported after organ transpl antation, but the level of risk as well as the histological features are po orly defined. Methods. A retrospective autopsy-based study was performed to evaluate rena l neoplasms occurring in patients who underwent solid organ transplantation , died, and received an autopsy from 1981 to 1997 (383 liver, 125 heart, 52 lung, 39 heart/lung, 98 kidney, 4 bowel), Patients were divided into those with short (less than 101 days), medium (101 days to 5 years), and long-te rm survival (more than 5 years). The control group consisted of hospital au topsies on nontransplanted patients from the odd-numbered years, 1983 throu gh 1997, Results, Renal cortical neoplasms were identified in 32/1325 of nontranspla nted patients and 15/701 transplanted patients. In transplanted patients, n eoplasms were identified in 14 native and 1 allograft kidney: 2/391 in shor t-term survivors, 3/234 in medium, and 10/76 in long term survivors. While transplant patients with short and medium length survival had no increased risk. for neoplasms, patients with long-term survival showed a 9-fold incre ase in cortical neoplasms. Transplant patients with neoplasms averaged 47 y ears of age at death, significantly younger than the average age of 70 for nontransplanted control patients with renal neoplasms. The neoplasms in tra nsplanted patients were all tubulopapillary, except for one clear cell neop lasm and ranged in size from 0.1 to 2 cm, Conclusions. Long-term survivors of solid organ transplants have an 9-fold increased risk of developing tubulopapillary renal cortical neoplasms.