{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T04:06:12Z","timestamp":1774497972584,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T00:00:00Z","timestamp":1755561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction and Aim: Renal transplant recipients face significant long-term graft and patient loss due to post-transplant malignancies. This study aimed to characterize post-transplant malignancies, determine mortality risk factors, and evaluate patient outcomes. Materials and Methods: This retrospective study included 2052 kidney transplant recipients who underwent transplantation between 1976 and 2019 at our institution, other national centers, or international facilities, and who had at least six months of follow-up. Regardless of the transplant center, all patients were followed exclusively at our nephrology department for post-transplant care. A comprehensive review of patient files was conducted, encompassing demographic data, malignancy type and treatment, mortality rates, tissue compatibility assessments, viral serology results, immunosuppression protocols, acute rejection history, and pre-transplant malignancies. The relationships between these variables and mortality were examined. Results: A total of 167 malignant events were observed in 163 patients out of 2052 renal transplant patients (7.9%). The female patients comprised 34.4% (n = 56) of the participants. Ages at transplantation and malignancy diagnosis had medians of 40.0 (13\u201372) and 50.0 (23\u201378) years, respectively. The leading malignancy was skin cancer at 30.0%, with Kaposi sarcoma at 11.3% and post-transplant lymphoproliferative disease at 10.6% following. Of the patients followed up, 58.9% (93 patients) had mortality. In univariate analysis, older age at transplant, older age at malignancy diagnosis, and male sex were associated with mortality; however, no independent predictors were identified in the multivariate model (all p &gt; 0.05), likely due to sample size limitations and inter-variable collinearity. Mortality showed statistically significant associations (p &lt; 0.05) with increased age at transplantation, increased age at malignancy diagnosis, and male gender. Conclusions: Post-transplant malignancies significantly compromise both graft longevity and patient survival. Particularly aggressive skin cancers demand heightened clinical vigilance. Early detection through regular dermatological screening, patient education, and timely biopsies must become integral to long-term transplant care protocols.<\/jats:p>","DOI":"10.3390\/jcm14165858","type":"journal-article","created":{"date-parts":[[2025,8,19]],"date-time":"2025-08-19T11:41:41Z","timestamp":1755603701000},"page":"5858","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Malignancies After Renal Transplantation: Frequency, Etiology, and Prognosis\u2014A Single Center Experience"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5664-7853","authenticated-orcid":false,"given":"Fatih","family":"Atalah","sequence":"first","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, 34720 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayd\u0131n","family":"Acarbay","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, 34720 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akg\u00fcn","family":"Karak\u00f6k","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, 34720 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet","family":"Be\u015firo\u011flu","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Istanbul Medeniyet University, 34720 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-154X","authenticated-orcid":false,"given":"Fatih","family":"Ku\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara Atat\u00fcrk Sanatoryum E\u011fitim ve Ara\u015ft\u0131rma Hastanesi, 06290 Ankara, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4128-8533","authenticated-orcid":false,"given":"Huzeyfe","family":"Ar\u0131c\u0131","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet Burak","family":"Dirim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vafa","family":"Suleymanova","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayd\u0131n","family":"T\u00fcrkmen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2526-3483","authenticated-orcid":false,"given":"Halil","family":"Yaz\u0131c\u0131","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medicine, Istanbul University, 34452 Istanbul, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Flythe, J.E., Karlsson, N., Sundgren, A., Cordero, P., Grandinetti, A., Cremisi, H., and Ryd\u00e9n, A. (2021). Development of a preliminary conceptual model of the patient experience of chronic kidney disease: A targeted literature review and analysis. BMC Nephrol., 22.","DOI":"10.1186\/s12882-021-02440-9"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1053\/j.ajkd.2020.11.017","article-title":"KDOQI US Commentary on the 2020 KDIGO Clinical Practice Guideline on the Evaluation and Management of Candidates for Kidney Transplantation","volume":"77","author":"Puttarajappa","year":"2021","journal-title":"Am. J. Kidney Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/MOT.0000000000001059","article-title":"Renal transplantation: The last iteration of the rest of the world","volume":"28","author":"Bradbrook","year":"2023","journal-title":"Curr. Opin. Organ. Transplant."},{"key":"ref_4","unstructured":"GODT (2025, March 05). Global Observatory on Donations and Transplantation. Available online: https:\/\/www.transplant-observatory.org\/."},{"key":"ref_5","unstructured":"ANZDATA (2025, March 05). Australia and New Zealand Dialysis and Transplant. Available online: http:\/\/www.anzdata.org.au."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S22","DOI":"10.1016\/j.ajt.2025.01.020","article-title":"OPTN\/SRTR 2023 Annual Data Report: Kidney","volume":"25","author":"Lentine","year":"2025","journal-title":"Am. J. Transplant."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"434","DOI":"10.2215\/CJN.14570920","article-title":"De Novo Malignancies after Kidney Transplantation","volume":"17","author":"Fowler","year":"2022","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_8","first-page":"e942074","article-title":"Current Trends and Future Directions of Malignancy After kidney Transplantation: A 1970\u20132022 Bibliometric Analysis","volume":"29","author":"Jiang","year":"2024","journal-title":"Ann. Transplant."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2809","DOI":"10.1016\/S0041-1345(01)02198-4","article-title":"Incidence and clinical characteristics of malignancies after renal transplantation: One center's experience","volume":"33","author":"Arican","year":"2001","journal-title":"Transplant. Proc."},{"key":"ref_10","first-page":"102","article-title":"Post-transplant Lymphoproliferative Disorder","volume":"65","author":"Chowdhary","year":"2017","journal-title":"J. Assoc. Physicians India"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5604\/01.3001.0054.9677","article-title":"The assesement of the long-term effects of kidney transplantation, including the incidence of malignant tumors, in recipients operated on between 2006 and 2015\u2014A cohort study and literature review","volume":"97","author":"Ciesielski","year":"2025","journal-title":"Pol. Przegl. Chir."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1775","DOI":"10.1016\/j.transproceed.2020.02.124","article-title":"Malignancy With Immunosuppression After Renal Transplantation: A Competing Risk Analysis","volume":"52","author":"Yoshida","year":"2020","journal-title":"Transplant. Proc."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Chukwu, C.A., Wu, H.H.L., Pullerits, K., Garland, S., Middleton, R., Chinnadurai, R., and Kalra, P.A. (2024). Incidence, Risk Factors, and Outcomes of De Novo Malignancy following Kidney Transplantation. J. Clin. Med., 13.","DOI":"10.3390\/jcm13071872"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1053\/j.ajkd.2014.08.019","article-title":"Utility and validity of estimated GFR-based surrogate time-to-event end points in CKD: A simulation study","volume":"64","author":"Greene","year":"2014","journal-title":"Am. J. Kidney Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1111\/j.1600-6143.2004.00450.x","article-title":"Cancer after kidney transplantation in the United States","volume":"4","author":"Kasiske","year":"2004","journal-title":"Am. J. Transplant."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"151494","DOI":"10.1016\/j.semnephrol.2024.151494","article-title":"Epidemiology of Cancer in Kidney Transplant Recipients","volume":"44","author":"Noel","year":"2024","journal-title":"Semin. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1891","DOI":"10.1001\/jama.2011.1592","article-title":"Spectrum of cancer risk among US solid organ transplant recipients","volume":"306","author":"Engels","year":"2011","journal-title":"JAMA"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Fr\u00f6hlich, F.A., Halleck, F., Lehner, L., Schrezenmeier, E.V., Naik, M., Schmidt, D., Khadzhynov, D., Kast, K., Budde, K., and Staeck, O. (2020). De-novo malignancies after kidney transplantation: A long-term observational study. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0242805"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"11614","DOI":"10.3389\/ti.2024.11614","article-title":"Incidence of De Novo Post-Transplant Malignancies in Thai Adult Kidney Transplant Recipients: A Single-Center, Population-Controlled, Retrospective Cohort Study at the Highest Volume Kidney Transplant Center in Thailand","volume":"37","author":"Srisuwarn","year":"2024","journal-title":"Transpl. Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1097\/01.TP.0000083897.44391.E8","article-title":"Incidence of cancer after kidney transplant: Results from the North Italy transplant program","volume":"76","author":"Pedotti","year":"2003","journal-title":"Transplantation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1053\/j.seminoncol.2014.12.032","article-title":"Human papillomaviruses and non-melanoma skin cancer","volume":"42","year":"2015","journal-title":"Semin. Oncol."},{"key":"ref_22","first-page":"e52527","article-title":"Evaluating Kaposi Sarcoma in Kidney Transplant Patients: A Systematic Review and Meta-Analysis","volume":"16","author":"Saowapa","year":"2024","journal-title":"Cureus"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1182\/hematology.2024000583","article-title":"EBV and post-transplant lymphoproliferative disorder: A complex relationship","volume":"2024","author":"Rouce","year":"2024","journal-title":"Hematol. Am. Soc. Hematol. Educ. Program."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1111\/ejh.13815","article-title":"Early- and late-onset posttransplant lymphoproliferative disorders among adult kidney and liver transplant recipients","volume":"109","author":"Abdulovski","year":"2022","journal-title":"Eur. J. Haematol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"151503","DOI":"10.1016\/j.semnephrol.2024.151503","article-title":"Post-Transplant Lymphoproliferative Disorders","volume":"44","author":"Dharnidharka","year":"2024","journal-title":"Semin. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1097\/QCO.0000000000000787","article-title":"Epstein-Barr virus posttransplant lymphoproliferative disorder: Update on management and outcomes","volume":"34","author":"Lindsay","year":"2021","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1111\/j.1600-6143.2004.00332.x","article-title":"Lack of improvement in renal allograft survival despite a marked decrease in acute rejection rates over the most recent era","volume":"4","author":"Schold","year":"2004","journal-title":"Am. J. Transplant."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"305","DOI":"10.4143\/crt.2023.647","article-title":"Incidence and Features of Lymphoid Proliferation and Lymphomas after Solid Organ or Hematopoietic Stem Cell Transplantation in a National Database Cohort","volume":"56","author":"Hahn","year":"2024","journal-title":"Cancer Res. Treat."},{"key":"ref_29","first-page":"813","article-title":"Sirolimus and mTOR Inhibitors: A Review of Side Effects and Specific Management in Solid Organ Transplantation","volume":"42","author":"Nguyen","year":"2019","journal-title":"Drug Saf."},{"key":"ref_30","first-page":"25","article-title":"Kaposi Sarcoma in the Era of Rapamycin Remains a Therapeutic Challenge in Organ Transplant Recipients","volume":"16","author":"Haberal","year":"2018","journal-title":"Exp. Clin. Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"187","DOI":"10.5114\/ada.2023.127637","article-title":"Non-melanoma skin cancer outcomes in kidney transplant recipients converted from calcineurin inhibitors to mTOR inhibitors: A systematic review","volume":"40","author":"Olszewska","year":"2023","journal-title":"Postep. Dermatol. Alergol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.trre.2017.10.002","article-title":"Cancer evaluation in the assessment of solid organ transplant candidates: A systematic review of clinical practice guidelines","volume":"32","author":"Acuna","year":"2018","journal-title":"Transplant. Rev."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1111\/j.1600-6143.2010.03181.x","article-title":"Comparison of the incidence of malignancy in recipients of different types of organ: A UK Registry audit","volume":"10","author":"Collett","year":"2010","journal-title":"Am. J. Transplant."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.transproceed.2023.03.048","article-title":"Outcome of Brain Lymphoma in a High Epstein-Barr Virus-Prevalence Country After Kidney Transplantation","volume":"55","author":"Huang","year":"2023","journal-title":"Transplant. Proc."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1292","DOI":"10.1093\/ndt\/gfz026","article-title":"Pre-existing malignancies in renal transplant candidates-time to reconsider waiting times","volume":"34","author":"Watschinger","year":"2019","journal-title":"Nephrol. Dial. Transplant."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/16\/5858\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:30:52Z","timestamp":1760034652000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/16\/5858"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,19]]},"references-count":35,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jcm14165858"],"URL":"https:\/\/doi.org\/10.3390\/jcm14165858","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,19]]}}}