Renal transplantation exposes patients with previous Kaposi's sarcoma to a high risk of recurrence

TitleRenal transplantation exposes patients with previous Kaposi's sarcoma to a high risk of recurrence
Publication TypeJournal Article
Year of Publication1996
AuthorsDoutrelepont JM, De Pauw L, Gruber SA, Dunn DL, Qunibi W, Kinnaert P, Vereerstraeten P, Penn I, Abramowicz D
JournalTransplantation
Volume62
Issue4
Pagination463 - 6
Date PublishedAug 27
Accession Number8781611
KeywordsAdult, Female, Humans, Immunocompromised Host, Kidney Transplantation / *adverse effects, Male, Middle Aged, Recurrence, Research Support, Non-U.S. Gov't, Risk Factors, Sarcoma, Kaposi / *complications
Abstract

It is currently estimated that about 0.5% of patients will develop Kaposi's sarcoma (KS) after kidney transplantation. Tapering of immunosuppression often leads to KS remission, but also results in graft loss in more than 50% of cases. Whether retransplantation is safe in these patients is unknown. We here report on eight patients who developed KS recurrence after kidney transplantation-(A) Patients with previously treated KS: There were 4 patients who had clinical remission of KS (including three posttransplantation) for periods ranging from 5 months up to 19 years before transplantation. All 4 developed KS recurrence within months after transplantation. In 3 patients, KS regressed only when all immunosuppression was discontinued, at the price of allograft removal. Partial remission occurred in the fourth patient following reduction of immunosuppression and gancyclovir administration; (B) Patients with recurrent KS during a single transplant: 4 patients developed KS after transplantation that regressed following reduction of immunosuppressive therapy. Increased immunosuppression, in the form of steroid pulses in 3 patients was associated with recurrence of KS. Subsequent reduction of immunosuppression caused regression of KS in all 4 patients, but 2 recipients lost their allografts. These data emphasize the high risk of recurrence of KS after renal transplantation. If physicians decide to transplant patients with a history of KS, they should inform the future recipient of the possibility of KS recurrence.

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