Waiting times in renal transplant candidates with a history of malignancy: time for a change?

Abstract:

PURPOSE OF REVIEW:With the aging population of kidney transplant candidates, a history of malignancy is an increasingly prevalent finding. Tumors can constitute a contraindication for transplantation or can lead to a delay of acceptance to the waiting-list. Current waiting time guidelines mainly refer to early data collected nearly 30 years ago, when the knowledge on tumors was, by current standards, still limited. RECENT FINDINGS:Today, cancers can usually be divided into many different biological subtypes, according to histological and molecular subclassification and the availability of genetic testing. A more precise stratification and targeted antitumor therapies have led to better therapy outcomes or even cures from certain malignancies and to a better appreciation of tumor risks for the patient. SUMMARY:Even though transplant patients do have an increased risk for malignancies, it is often overlooked that patients, while on dialysis, are equally prone to develop a tumor. Competing risks (e.g. cardiovascular, mortality risks) through prolonged time on dialysis have to be equally considered, when the decision for acceptance of a patient to the waiting-list is made. Current waiting time suggestions should be critically reconsidered for every patient after a thorough discussion with an oncologist, including new diagnostic and therapeutic strategies, as well as novel risk stratifications.

authors

Bojic M,Watschinger C,Reiter T,Watschinger B

doi

10.1097/MNH.0000000000000652

subject

Has Abstract

pub_date

2020-11-01 00:00:00

pages

623-629

issue

6

eissn

1062-4821

issn

1473-6543

journal_volume

29

pub_type

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