Post-Kidney Transplantation Malignancy: Risk, Pathogenesis, and Management

Abstract

The rising incidence of cancer in kidney transplant patients poses a significant barrier to longterm patient and graft survival. Immunosuppression is a primary component in cancer risk, although the interaction of recipient characteristics, viral oncogenesis, and donor-related factors complicates risk assessment. Current research highlights the increased prevalence and mortality linked to some malignancies, including lymphomas, skin cancers, and virus-associated tumors, as well as the limited effectiveness of some existing preventative and treatment approaches. Despite progress, significant challenges persist, particularly in balancing immunosuppression and cancer control, defining the role of prophylactic vaccinations, and validating customized screening techniques. This review examines the pathophysiological mechanisms, evaluates guidelines, and presents contemporary data on the incidence and management of post-kidney transplantation malignancies, highlighting both recent advances and unresolved issues. The current evidence, largely constrained by observational and registry-based studies, underscores the urgent need for prospective research. There is an urgent requirement for prospective research to enhance personalized care, facilitate early detection, and provide safer immunosuppressive protocols. Collaboration among nephrology, oncology, and infectious disease specialists is crucial to improve care and increase survival in this at-risk group.