Kidney transplantation (KT) is an increasingly used medical procedure for treating otherwise
fatal end stage renal diseases (ESRD); this success was obtained with the use of potent
immunosuppressive agents able to reduce the risk of rejection of transplanted organs, but exposing
patients to an increased risk of opportunistic diseases such infections or cancers, this latter representing
nowadays the second major cause of morbidity and mortality after KT. KT recipients (KTR) experience
a 2- to 4-fold increase of de novo post-transplant malignancies (PTM) when compared to the general
population, particularly skin cancers, urological malignancies and virus-related cancers such as non-
Hodgkin lymphoma (NHL) or Kaposi’s sarcoma (KS) with up to 100-fold augmented risk when
compared to the general population. Given the improved graft and patient survival that have lengthened
the observation period for the natural history of immunosuppressed recipients and their increasing age,
we can expect that over the next decades mortality from malignancy may represents the leading cause
of death in transplanted patients. As the immunosuppression per se and various potentially oncogenic
viruses play a major role in cancer development after transplant, a better definition of this phenomenon
can lead to the adoption of preventive measure to reduce the risk of PTM or the implementation of
better screening protocols to earlier detect malignancies. This chapter examines, from an
epidemiological point of view, the incidence, etiology and prognosis of malignancies after kidney
transplantation with a focus on those associated with viral infections..
Keywords: Post-Transplant Malignancies, Viruses and Cancer, Kaposi’s Sarcoma, Epstein-Barr Virus, Post-
Transplant Lymphoproliferative Disorders, Skin Cancer, Renal Cell Carcinoma, Everolimus, Sirolimus.
