[Risk factors for cancer development in patients after kidney transplantation]

Abstract

Kidney transplantation in patients with ESRD (end-stage renal disease) improves quality of life and is associated with an increase in both survival rates and the reduction in medical costs compared with patients waiting for a transplant as well as dialysis population. Cancers, next to the cardiovascular disease and infection, present as one of the most common causes of kidney transplant recipients deaths. Incidence of neoplasm after kidney transplantation is between 2.3 and 31%. Risk factors for carcinogenesis after transplantation can be divided into three main groups which include traditional factors (genetic predisposition, exposure to UVA and UVB radiation, smoking, abuse of painkillers, cancer in the pretransplant period), factors connected with kidney disease (cause and treatment of kidney failure) and related to transplantation (immunosuppressive regimen, chronic viral infection, cancer transition with graft). Immunosuppressive treatment undoubtedly has a huge impact on the development of tumours in patients after transplantation. It is to be remembered to include mTOR inhibitors in immunosuppressive regimen in patients with a history of cancer. In kidney recipients the frequency of reactivation as well as de novo infection of oncogenic virus is increased, particularly: EBV (Epstein-Barr virus), HBV (hepatitis type B virus), HCV (hepatitis type C virus), HPV (human papilloma virus) i HHV8 (human herpes virus type 8). An important aspect is the awareness of patients about the increased risk of cancer development and necessity of respecting and applying of preventive recommendations.