Re: Bladder Cancer in Renal Allograft Recipients: Risk Factors and Outcomes

Malignancy is the second most important cause of death after cardiovascular disease in kidney transplant recipients (KTR) with a functioning allograft due to\udload of immunosuppression and oncologic viral infections. The authors have reviewed the Irish National Cancer Registry and National Renal Transplant registry\udto find the incidence and types of de novo developing bladder cancers in KTR who were transplanted between 1994 and 2012 in Ireland. A total of 15 patients\udrepresenting 0.48% of the KTR were found to have a 2.5 fold increased risk of bladder malignancy compared with the general population in Ireland. Tumors\udwere diagnosed in a younger population, at a more advanced stage, with a worse 1-year overall survival. Besides, immunosuppression preexisting genitourinary\uddiseases, toxic nephropathies, and cyclophosphamide exposure and BK-induced nephropathy have been identified as extra risk factors. However, different\udethnical populations might have distinct risk factors, such as exposure to Chinese herbs and, arsenic found in underground water sources as if found in Chinese\udpopulation. Identifying patients with preexisting risk factors in the population and careful posttransplant monitoring with a low threshold for cystoscopy may\udimprove outcomes in KTR