Diagnostic And Therapeutic Analysis Of New Malignancy In Recipients Of Kidney Transplantation

BackgroundCompared with traditional dialysis treatment,nowadays,renal transplantation has significantly improved the survival rate and quality of life of uremia patients.And,renal transplantation is the best treatment for end-stage renal disease.However,with the extension of the survival time of renal transplant recipients,the incidence of malignant tumors is increasing gradually after renal transplantation.At the same time,because of the application of immunosuppressant,the survival rate of renal transplant recipients with malignant tumor than normal population declines obviously,has become the important factors affecting the long-term survival of renal transplant recipients.ObjectiveBy analyzing and summarizing the occurrence of malignant tumor after renal transplantation,explore the pathogenesis,treatment,prognosis and prevention of new malignant tumor after kidney transplantation.MethodsReview the clinical data of renal transplant recipients in qianfoshan hospital of shandong province from June 1997 to June 2008,and analyze the cases with new malignant tumors after renal transplantation retrospectively.ResultsThere are 13 cases of malignant tumors,with an overall incidence of 3.13%,and the onset age is between 41 and 65 years,with an average age of 50.5 years.The time of diagnosis is 8～160months after kidney transplantation,with an average of 69.7 months.The 1-year survival rate is 84.6%,and the 5-year survival rate is 53.8%.In 13 cases of malignant tumors,the original renal pelvis carcinoma 4 cases,the original kidney carcinoma 1 case,carcinoma of urinary bladder 2 cases,ureter tumor 2 cases,lymphatic proliferative disease after transplantation(PTLD)1 case,colorectal cancer 1 case,thyroid carcinoma 2 cases.All the 13 patients were treated with surgery,supplemented by chemoradiotherapy and immunosuppressive therapy.Five cases are still alive.ConclusionThe incidence of malignant tumors in renal transplant recipients is significantly higher than that of normal patients,and the incidence of urinary system tumors was the highest.The application of immunosuppressive drugs is the main cause of tumor after kidney transplantation.Postoperative standard and complete reexamination can help early detection of tumor.The treatment should be based on the patient’s comprehensive condition,with radical surgical resection,combined with chemoradiotherapy,while reducing the dosage of immunosuppressive agents and adjusting the medication regimen.