Abstract: FR-PO782
Kaposi Sarcoma Involving the Renal Allograft: Report of Two Cases
Session Information
- Post-Transplantation and Case Reports
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Transplantation
- 2102 Transplantation: Clinical
Authors
- Murshed, Khaled, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
- Elshirbeny, Mostafa, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
- Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
- Nauman, Awais, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
Introduction
The use of immunosuppressive agents for prevention of allograft rejection increases the risk of malignancy. The magnitude of the higher risk is dependent on cancer types, with the greatest risk in viral-related and immune driven cancers such as post-transplant lymphoproliferative disease (PTLD) and Kaposi sarcoma (KS). Involvement of the renal allograft by KS is extremely rare. Here, we present two cases of KS involving the renal allograft
Case Description
Case 1: Sudanese gentleman who was diagnosed to have ESRD. He had live unrelated kidney transplant in June 2014. His course was unremarkable till 7/2015 when he presented with acute graft dysfunction and MRI abdomen revealed: bulky transplanted kidney with multiple liver, splenic and vertebral lesions. Anti-human herpes virus 8 (HHV-8) antibody was positive and transplanted kidney and liver biopsies revealed KS. Immunosuppression was reduced and patient experienced improving general condition later.
Case 2: 46 years old Mozambican gentleman, known case of ESRD. Underwent living unrelated renal transplant then 10 months after transplant, patient was admitted with rising serum creatinine and pancytopenia. Transplanted kidney biopsy revealed: extensive infiltration by Kaposi sarcoma with negative C4d and SV-40. HHV8 was positive in the nuclei of most of the tumor cells. Then patient decided to return back to his home country.
Discussion
Kaposi sarcoma (KS) was first reported in 1872 by Moritz Kaposi, a Hungarian physician. Several reports have documented an endemic form of KS mostly encountered in Africa. Indeed, the incidence of KS is now known to reflect differences in the prevalence of Kaposi Sarcoma Virus (KSHV). This virus is also called Human Herpes Virus8 (HHV8). Patient 1 was from Sudan which generally not considered a Sub-Saharan country but it nevertheless has high incidence of KS. Patient 2 was from Mozambique, a country in Sub Saharan known to have high incidence of KS. Involvement of the renal allograft by KS however is extremely rare with only eight cases reported in the literature. The patient’s age ranged from 28 to 71 year and in all cases, KS was diagnosed within 12 months after transplantation. Reduction of immunosuppression resulted in regression of the tumor in most cases. In conclusion we present 2 cases of KS in the renal allograft which brings the number of cases to 10.