Abbaszadeh Shahin, Taheri Saeed
Dr. Taheri Medical Research Group, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Saudi J Kidney Dis Transpl. 2009 Sep;20(5):775-8.
In this study, we aimed to evaluate the incidence, features and outcome of post transplant KS among Iranian recipients of living kidney allograft. We studied 2211 kidney allograft recipients who underwent living renal transplantation at our center between January 1984 and August 2007. All patients in our study received cyclosporine based immunosuppressive agents. The diagnosis of KS was confirmed with pathological evaluations of tissue biopsy specimens. There were 10 of 2211 (0.45%) incident cases of KS kidney transplant population at our center during a mean follow up of 57 +/- 38 months. Of the 10 KS patients, 8 were males and two were females with a median age of 52 years. The median time from transplantation to the development of KS was 8 months. Overall, two (20%) patients developed visceral involvement (one eye, one bladder), and eight patients manifested only KS restricted to the skin. Immunosuppression was reduced in 5 patients and thoroughly withdrawn in the remainder (including two cases of visceral involvement); KS did not abate in the patient with bladder involvement. All the KS patients remained alive after a mean of 35.6 +/- 39.3 months of follow up; two patients lost their allograft and underwent dialysis (one after 3 months and one another after 4 months of KS diagnosis). The KS patients were significantly older at their transplantation time (P= 0.008; [Table 1]). Survival analysis using Kaplan Meier method and log-rank test revealed no difference in graft and patient survival between both groups. In conclusion, we found low incidence of KS in our living renal transplant recipients. The outcome of the KS patients was excellent with low morbidity and mortality. The incidence of KS was significantly associated with an older age at transplantation time for the allograft recipients. Further studies with larger patient population are warranted to confirm our results.
在本研究中，我们旨在评估伊朗活体肾移植受者中移植后卡波西肉瘤（KS）的发病率、特征及预后。我们研究了1984年1月至2007年8月间在本中心接受活体肾移植的2211例肾移植受者。本研究中的所有患者均接受以环孢素为基础的免疫抑制剂治疗。KS的诊断通过组织活检标本的病理评估得以证实。在平均57±38个月的随访期间，本中心2211例肾移植人群中有10例（0.45%）发生了KS。10例KS患者中，8例为男性，2例为女性，中位年龄为52岁。从移植到发生KS的中位时间为8个月。总体而言，2例（20%）患者出现内脏受累（1例眼部、1例膀胱），8例患者仅表现为局限于皮肤的KS。5例患者减少了免疫抑制，其余患者（包括2例内脏受累患者）完全停用了免疫抑制；膀胱受累的患者KS并未减轻。在平均35.6±39.3个月的随访后，所有KS患者均存活；2例患者移植肾失功并接受了透析（1例在KS诊断后3个月，另1例在4个月后）。KS患者移植时年龄显著更大（P = 0.008；[表1]）。使用Kaplan-Meier方法和对数秩检验进行的生存分析显示，两组间移植肾和患者生存率无差异。总之，我们发现我们的活体肾移植受者中KS发病率较低。KS患者的预后良好，发病率和死亡率较低。KS的发病率与移植时受者年龄较大显著相关。有必要进行更大规模患者群体的进一步研究以证实我们的结果。
