Kaposi's sarcoma in liver transplant recipients: Morphological and clinical description

The clinical course and outcome of 5 adult patients who underwent orthotopi c liver transplantation (OLT) and developed Kaposi's sarcoma (KS) is report ed. From October 1986 to July 2000, a total of 459 patients underwent 499 O LTs at oar hospital. The immunosuppressive regimen consisted of cyclosporin e, azathioprine, prednisone, and antithymocyte globulin. Tacrolimus was adm inistered only in selected patients. Five patients developed KS, and the pa thological diagnosis was established months 9 to 23 after OLT. Four of 5 pa tients died of KS, surviving 0 to 6 months after pathological diagnosis. Th e fifth patient, with KS confined to the skin, is disease free 6 months aft er diagnosis. Aft patients were treated with reduction of immunosuppressive therapy and/or chemotherapy. Retrospective molecular investigation by poly merase chain reaction for human herpesvirus type 8 DNA detected specific vi ral sequences in histological specimens of tissues involved by KS. In our e xperience with adult liver transplant recipients, we registered a slightly lower prevalence of KS compared with other reported data, but observed a hi gh rate of graft involvement and mortality.