Introduction: Desensitization (DS) in kidney transplant is a current therapy for all cause of incompatible living donor kidney transplants (LDKT). The impact in cancer risk of this over-immunosuppression is not well established. Our aim is to study the incidence of posttransplant malignancies in kidney transplant patients under DS.

Method: LDKT (2006-2013) receiving DS therapy (rituximab, plasma exchange/ immunoadsortion, IGIV) were enrolled. The control group was LDKT without this therapy in the same data. All patients signed inform consent, and the study was approved by the Ethics Committee of our Institution.

Results: 387 LDKT were included, 78 receiving DS protocol before the transplant (ABO incompatible: 48; Positive crossmatch: 25; Both: 3; Others: 2). Median age was 48.03+/-13.69yrs(20-82), and 62% were males. 21 patients were diagnosed of neoplasia after the transplant (5.4%). 15 non-skin tumors: 13 solid organ tumors (5 lung;3 prostate;1 kidney;others), 1 PTLD, and 1 Kaposi sarcoma. 16% had pretransplant neoplasia, and 5.2% premalignant lesions. Patients with neoplasia under CNI were 70%, 20% mTORi, and 10% both. sCr at tumor:1.42+/-0.98 mg/dl. Patient survival (p<0.05), age at transplant (p=0.031), and smoke (p=0.012) were significantly associated with neoplasia. 21 deaths: 38,1% were by cancer (87,5% in the neoplasia group). Only cancer (p=0.010) were associated with death by neoplasia. DS and immunosuppressive therapy were not associated with neoplasia or death by neoplasia. Acute rejection by biopsia (p=0.027), diabetes (p=0.034), HTA (p=0.017), and ethiology of CKD (p= 0.046) were associated with the use of DS, but not with neoplasia either death by neoplasia.

Conclusion: The use of DS is not associated with posttransplant malignancy either the death by neoplasia in incompatibility LDKT.

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