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Review
. 2023 Dec 19;16(1):3.
doi: 10.3390/cancers16010003.

Renal Cell Carcinoma in End-Stage Kidney Disease and the Role of Transplantation

Samuel Robinson  1   2 , Alena Nag  2 , Benjamin Peticca  1   2 , Tomas Prudencio  1   2 , Antonio Di Carlo  1   2 , Sunil Karhadkar  1   2
Affiliations
Review

Renal Cell Carcinoma in End-Stage Kidney Disease and the Role of Transplantation

Samuel Robinson et al. Cancers (Basel). .

Abstract

Kidney transplant patients have a higher risk of renal cell carcinoma (RCC) compared to non-transplanted end-stage kidney disease (ESKD) patients. This increased risk has largely been associated with the use of immunosuppression; however, recent genetic research highlights the significance of tissue specificity in cancer driver genes. The implication of tissue specificity becomes more obscure when addressing transplant patients, as two distinct metabolic environments are present within one individual. The oncogenic potential of donor renal tissue is largely unknown but assumed to pose minimal risk to the kidney transplant recipient (KTR). Our review challenges this notion by examining how donor and recipient microenvironments impact a transplant recipient's associated risk of renal cell carcinoma. In doing so, we attempt to encapsulate how ESKD-RCC and KTR-RCC differ in their incidence, pathogenesis, outcome, and approach to management.

Keywords: dialysis; end-stage renal disease; immunosuppression; kidney transplant; renal cell carcinoma; renal malignancy; transplantation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Triangular cause and effect diagram, visualizing the bidirectional relationships between RCC, ESKD, and transplantation.
Figure 2
Figure 2
Diagram demonstrating the risks attributed to renal transplantation patients and their underlying origin (recipient-based or transplantation-based). All risk factors are discussed further in the review.
Figure 3
Figure 3
Longitudinal display of the incidence of kidney transplantation patients diagnosed with RCC at the time of transplantation. Data extracted from the UNOS database on 2 July 2022. Trendlines displayed.
Figure 4
Figure 4
Longitudinal display of the incidence of kidney transplantation patients diagnosed with de novo RCC after transplantation. Data extracted from the UNOS database on 2 July 2022. Trend lines displayed.
Figure 5
Figure 5
Pie chart displaying the leading causes of death for patients after receiving a kidney transplantation. Data were extracted from the UNOS database on 2 July 2022.
See this image and copyright information in PMC

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