Kaposi's sarcoma in kidney transplant recipients: A 23-year experience

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dc.contributor.authorMoosa M.R.
dc.date.accessioned2011-05-15T16:17:47Z
dc.date.available2011-05-15T16:17:47Z
dc.date.issued2005
dc.description.abstractBackground: Kaposi's sarcoma (KS) is a relatively common malignancy after kidney transplantation, accounting for up to 80% of all malignancies in developing countries. Aim: To assess the frequency of KS in renal transplant recipients, and determine the impact of demographic factors, immunosuppression and treatment options. Design: Retrospective study in a single centre in South Africa. Methods: Charts and pathology reports of 542 recipients of 623 kidney allografts treated at our institution between 1976 and 1999 were reviewed. Results: After a mean follow-up of 6.4 years, 21 (3.9%) recipients had KS, representing 47.7% of all post-transplant malignancies. KS accounted for more post-transplant cancers in non-White than White patients (79.1% vs. 11.7%, p < 0.001). KS was equally common in males and females, and was not more frequent under cyclosporine. Skin involvement was universal; visceral disease occurred in six patients (28.6%). Sixteen (94.1%) patients with limited skin disease and two (100%) with superficial nodal disease responded to withdrawal or reduction of immunosuppression. Renal function was preserved when immunosuppression was reduced instead of withdrawn (p=0.02). Patients with vital organ involvement succumbed rapidly to KS. Post-mortem examination revealed more extensive disease than was suspected clinically. Discussion: Ethnic differences exist in the frequency of KS in patients residing in the same geographical area. Since withdrawal results in graft loss, reducing immunosuppression should be first-line treatment for patients with disease limited to skin, and possibly for disease of the superficial lymph nodes. The malignant behaviour of KS, and extent of pathological involvement, cast doubt on the idea that KS is a hyperplasia rather than a true malignancy. © The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved.
dc.description.versionArticle
dc.identifier.citationQJM - Monthly Journal of the Association of Physicians
dc.identifier.citation98
dc.identifier.citation3
dc.identifier.issn14602725
dc.identifier.other10.1093/qjmed/hci028
dc.identifier.urihttp://hdl.handle.net/10019.1/14370
dc.subjectazathioprine
dc.subjectcyclosporin
dc.subjectmethylprednisolone
dc.subjectmycophenolic acid 2 morpholinoethyl ester
dc.subjectOKT 3
dc.subjectadult
dc.subjectarticle
dc.subjectautopsy
dc.subjectbreast cancer
dc.subjectcancer radiotherapy
dc.subjectCaucasian
dc.subjectcontrolled study
dc.subjectdeath
dc.subjectdemography
dc.subjectdrug withdrawal
dc.subjectenteropathy
dc.subjectethnic difference
dc.subjectfemale
dc.subjectfollow up
dc.subjectgraft rejection
dc.subjecthistopathology
dc.subjecthuman
dc.subjectKaposi sarcoma
dc.subjectkidney allograft
dc.subjectkidney cancer
dc.subjectkidney failure
dc.subjectkidney function
dc.subjectkidney transplantation
dc.subjectliver cancer
dc.subjectlung cancer
dc.subjectlymphadenopathy
dc.subjectlymphoma
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmedical assessment
dc.subjectmedical decision making
dc.subjectmedical record
dc.subjectmelanoma
dc.subjectmorbidity
dc.subjectpriority journal
dc.subjectrace difference
dc.subjectrecipient
dc.subjectretrospective study
dc.subjectsex difference
dc.subjectSouth Africa
dc.subjectthyroid cancer
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAfrican Continental Ancestry Group
dc.subjectChild
dc.subjectFemale
dc.subjectGraft Survival
dc.subjectHistocompatibility Testing
dc.subjectHumans
dc.subjectImmunocompromised Host
dc.subjectImmunosuppressive Agents
dc.subjectKidney Transplantation
dc.subjectLymphatic Metastasis
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectRetrospective Studies
dc.subjectSarcoma, Kaposi
dc.subjectSkin Neoplasms
dc.subjectSouth Africa
dc.subjectTreatment Outcome
dc.titleKaposi's sarcoma in kidney transplant recipients: A 23-year experience
dc.typeArticle
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