Pośpiech M, Kolonko A, Nieszporek T, Kozak S, Kozaczka A, Karkoszka H, Winder M, Chudek J. Transplanted kidney loss during colorectal cancer chemotherapy: A case report. World J Clin Cases 2022; 10(19): 6647-6655 [PMID: 35979324 DOI: 10.12998/wjcc.v10.i19.6647]
Corresponding Author of This Article
Sylwia Kozak, Department of Internal Diseases and Oncological Chemotherapy, Medical University of Silesia in Katowice, Reymonta 8, Katowice 40-027, Poland. sylwiakozak@icloud.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 6, 2022; 10(19): 6647-6655 Published online Jul 6, 2022. doi: 10.12998/wjcc.v10.i19.6647
Transplanted kidney loss during colorectal cancer chemotherapy: A case report
Marta Pośpiech, Aureliusz Kolonko, Teresa Nieszporek, Sylwia Kozak, Anna Kozaczka, Henryk Karkoszka, Mateusz Winder, Jerzy Chudek
Marta Pośpiech, Sylwia Kozak, Jerzy Chudek, Department of Internal Diseases and Oncological Chemotherapy, Medical University of Silesia in Katowice, Katowice 40-027, Poland
Aureliusz Kolonko, Henryk Karkoszka, Department of Nephrology, Transplantation and Internal Medicine, Medical University of Silesia in Katowice, Katowice 40-027, Poland
Teresa Nieszporek, Department of Nephrology, Transplantation and Internal Medicine, Mielecki Clinical Hospital of the Medical University of Silesia, Katowice 40-027, Poland
Anna Kozaczka, Department of Internal Diseases and Oncological Chemotherapy, Mielecki Clinical Hospital, Katowice 40-027, Poland
Mateusz Winder, Department of Radiology and Nuclear Medicine, Medical University of Silesia in Katowice, Katowice 40-752, Poland
Author contributions: Kozaczka A, Chudek J and Nieszporek T collected the clinical data; Pośpiech M and Kozak S designed the case report, reviewed the literature and drafted the manuscript; Karkoszka H performed and interpreted the kidney histology; Winder M prepared and interpreted the imaging; Chudek J and Kolonko A critically reviewed the manuscript; All authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sylwia Kozak, Department of Internal Diseases and Oncological Chemotherapy, Medical University of Silesia in Katowice, Reymonta 8, Katowice 40-027, Poland. sylwiakozak@icloud.com
Received: December 14, 2021 Peer-review started: December 14, 2021 First decision: February 14, 2022 Revised: March 2, 2022 Accepted: April 22, 2022 Article in press: April 22, 2022 Published online: July 6, 2022
Abstract
BACKGROUND
The overall risk of de novo malignancies in kidney transplant recipients (KTRs) is higher than that in the general population. It is associated with long-lasting exposure to immunosuppressive agents and impaired oncological vigilance due to chronic kidney disease. Colorectal cancer (CRC), frequently diagnosed in an advanced stage, is one of the most common malignancies in this cohort and is associated with poor prognosis. Still, because of the scarcity of data concerning adjuvant chemotherapy in this group, there are no clear guidelines for the specific management of the CRCs in KTRs. We present a patient who lost her transplanted kidney shortly after initiation of adjuvant chemotherapy for colon cancer.
CASE SUMMARY
A 36-year-old woman with a medical history of kidney transplantation (2005) because of end-stage kidney disease, secondary to chronic glomerular nephritis, and long-term immunosuppression was diagnosed with locally advanced pT4AN1BM0 (clinical stage III) colon adenocarcinoma G2. After right hemicolectomy, the patient was qualified to receive adjuvant chemotherapy that consisted of oxaliplatin, leucovorin and 5-fluorouracil (FOLFOX-4). The deterioration of kidney graft function after two cycles caused chemotherapy cessation and initiation of hemodialysis therapy after a few months. Shortly after that, the patient started palliative chemotherapy because of cancer recurrence with intraperitoneal spread.
CONCLUSION
Initiation of adjuvant chemotherapy for colon cancer increases the risk of rapid kidney graft loss driven also by under-immunosuppression.
Core tip: The occurrence of colorectal cancer (CRC) in kidney transplant recipients is higher than that in the general population. Advanced stage CRC is usually associated with poor outcome. Adjuvant chemotherapy may accelerate the graft loss after kidney transplant.
