Abstract: TH-PO845
Increased Incidence of Kaposi Sarcoma Among African and Hispanic Kidney Transplant Recipients
Session Information
- Transplantation: Clinical - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Pattison, Lindsay M., Montefiore Medical Center, Bronx, New York, United States
- Toker, Michelle, Montefiore Medical Center, Bronx, New York, United States
- Liriano-Ward, Luz E., Montefiore Medical Center, Bronx, New York, United States
- Al Azzi, Yorg, Montefiore Medical Center, Bronx, New York, United States
- Ajaimy, Maria, Montefiore Medical Center, Bronx, New York, United States
- Akalin, Enver, Montefiore Medical Center, Bronx, New York, United States
- Jain, Swati, Montefiore Medical Center, Bronx, New York, United States
- Mclellan, Beth N., Montefiore Medical Center, Bronx, New York, United States
- Pynadath, Cindy T., Montefiore Medical Center, Bronx, New York, United States
Background
Post-transplant Kaposi’s sarcoma (PTKS) is a rare complication among transplant patients. However, the incidence of PTKS is 100-500 times higher than Kaposi’s sarcoma (KS) in the general population. There have been no retrospective analyses characterizing increased incidence of PTKS among racial minorities in the U.S.
Methods
We performed an IRB-approved retrospective analysis of all adult patients greater than 18 years of age diagnosed with KS at Montefiore Medical Center. We reviewed electronic medical records based on ICD-9/10 code between the dates of 01/01/2014 – 09/01/2022 and identified 80 patients with KS, 10 of which were diagnosed with PTKS. Nine patients with PTKS after kidney transplant were included and 1 patient with PTKS after bone marrow transplant was excluded.
Results
Of the 9 patients that received kidney transplants and subsequently developed PTKS, 3 were female and 6 were male. All patients were minorities, with 6 African American and 3 Hispanic patients. Median age at transplantation was 60 years (range 44-70). Average time elapsed between transplant and PTKS development was 832.3±834.97 days (range 125-2630). Anatomic locations of PTKS lesions in patients included lower extremities (n=5), upper extremities (n=3), lymph nodes (n=3), kidney (n=1), and lung (n=1). Immunosuppression included tacrolimus (n=9), mycophenolate (n=7), cyclosporine (n=1), and steroids (n=10). After PTKS diagnosis, 7 patients had immunosuppression switched to sirolimus, 1 patient had tacrolimus and mycophenolate reduced, and 1 patient expired before treatment modification. All patients continued steroids. Four patients required additional treatment including radiotherapy (n=2), excision (n=1), and excision and imiquimod (n=1). One patient experienced PTKS recurrence approximately 18 months after initial resolution. Mortality was high (44%), and 4 patients died at a median of 95 days (range 19-1760) after diagnosis.
Conclusion
This study demonstrates high mortality rate in PTKS patients in minority kidney transplant recipients.