Clinical features of Kaposi's sarcoma in Croatian renal transplant recipients

Abstract

Aim: To investigate the prevalence, clinical manifestations and outcome of Kaposi's sarcoma in Croatian renal transplant recipients.

Methods: The Department database was retrospectively analysed according to clinical presentation, immunosuppressive protocol, treatment, and outcome of patients with Kaposi's sarcoma.

Results: Kaposi's sarcoma occurred in four male patients (0.67% of all renal transplant recipients), with the onset of clinical presentation at 4 to 18 months of transplantation. HLA-B35 was present in all patients, whereas HLA-A2, -DR3 and -DR5 were present in three patients each. In all patients, the disease manifested with purple or bluish papules on the skin, without visceral organ or lymph node involvement. Immunosuppression was rapidly reduced in the first patient who rejected the graft. Three patients achieved complete remission upon reduction of immunosuppressive therapy and local irradiation, with preserved renal function.

Conclusion: Kaposi's sarcoma is rare in Croatian renal transplant recipients. It tends to occur in male patients, soon after transplantation and is associated with HLA-B35. Reduction of immunosuppression is recommended as the first choice method in patients with skin-limited disease, accompanied by radiotherapy in resistant cases.