Woman Gets Cancer From Transplanted Kidney

NEW YORK (Reuters Health) - For a person with failing kidneys, receiving a transplanted kidney can be a lifesaver. But a new report shows that, in rare cases, the transplanted organ may pass on cancer to the recipient.

Wisconsin researchers report that a transplant recipient whose donor had previously had lung cancer developed cancer herself several years after her transplant. The woman has made a full recovery, but her case underscores the importance of closely following patients after organ transplantation, according to researchers led by Dr. Sigurdur Bodvarsson of the University of Wisconsin-Madison.

People who receive an organ transplant are known to have an increased risk of several types of cancer, including Kaposi sarcoma, non-Hodgkin lymphoma and non-melanoma skin cancers. The inability to fight off cancer-causing viruses due to a suppressed immune system as well as the effects of anti-rejection drugs are thought to account for some of this increased cancer risk.

In a report in the November 1st issue of the journal Cancer, however, Bodvarsson's team documents the case of a 25-year-old kidney transplant recipient who contracted cancer through her donated organ.

After the surgery, the woman was doing well, but 32 months after her transplant, she developed signs of Cushing's syndrome, a condition caused by an increased concentration of adrenocorticotropic hormone (ACTH) in the blood. The patient's symptoms included swelling, muscle weakness, weight gain, unusual hair growth, acne and a tendency to bruise easily.

Testing of the kidney and lymph glands revealed a type of cancer called small cell carcinoma in the transplanted kidney. The disease was also detected in the liver.

Analysis of the cancer cells and the patient's normal tissue indicated that the cancer had its start in the donated organ. The relative who had donated the kidney had been diagnosed with small cell carcinoma of the lung nearly 2 years before donating a kidney, the authors point out.

Once the cancer was diagnosed in the transplant recipient, doctors took her off immune-suppressing drugs in hopes of letting her body reject the cancer. But her immune system did not reject the cancer, possibly because of persistent high levels of ACTH, the researchers note.

At this point, the patient began chemotherapy to directly treat the cancer. A year after completing several rounds of chemotherapy, the patient remains in remission from cancer, Bodvarsson and colleagues report.

SOURCE: Cancer 2001;92:2429-2434.

This article posted December 29, 2001.

Woman Gets Cancer From Transplanted Kidney

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