Kaposi sarcoma after kidney transplantation : a study of 10 cases from a series of 580 kidney transplantations in a university hospital in Damascus, Syria

الملخص AR

Objective: Kaposi sarcoma (KS) occurs in 0.25-5% of cases after kidney transplantation (KT).

The objective of this study is to report the incidence of KS after KT in our experience, the presenting symptoms, the modality of diagnosis, the types of treatment, and the outcome of our cases in comparison with other series in the literature.

Methods: Between October 1985 and December 2004, 580 KT from living related donors (LRD) and living unrelated donors (LURD) were performed at Al-Moussat University Hospital, Damascus, Syria.

The diagnosis was confirmed in all cases by cutaneous and/or visceral biopsies.

The treatment consisted of cyclosporine withdrawal and reduction of the doses of other immunosuppressant medication.

This was applied to all patients with cutaneous lesions.

The previous measures were applied to patients with cutaneous and visceral lesions, in addition to chemotherapy which was given to one patient.

Resection of the TK was refused by all patients with cutaneous and visceral lesions.

The patients were followed-up for at least 3 years after the diagnosis of KS or until their death from the disease.

Results: Ten cases of KS of 580 KTs were diagnosed (1.7%).

Five patients had exclusively cutaneous KS, and the remaining five patients had cutaneous and visceral lesions.

The age range of the patients at the time of diagnosis was 18-45 years (mean 37.3).

All of our patients were males.

The delay between the time of KT and the diagnosis of KS was 3.5-16 months (mean 11.1 months).

The follow-up period was 4-42 months (mean: 25.5 months).

Four patients with cutaneous lesions have complete regression of their lesions within six months after treatment, and one patient has partial regression after two months.

All of them are alive on follow up with the development of chronic rejection in three patients.

Four of five patients with cutaneous and visceral lesions died within 4-16 months after treatment.

Complete regression of cutaneous and visceral lesions was noted in one patient who developed chronic rejection.

Conclusion: The incidence of KS after KT in this series is more frequent than is observed in western countries and less frequent than is observed in neighboring countries such as Saudi Arabia.

The visceral form of KS is more prevalent in this series with a more dismal prognosis