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Lung Cancer in Renal Transplant Recipients


Introduction. Although the incidence of malignancy has increased after solid organ transplantation, data on lung cancer in this group of patients is scarce. The aim of this study was to determine clinical characteristics and outcome of patients who developed lung cancer after renal transplantation. Methods. Among a cohort of 1658 patients who received a transplant at our institution and were followedup between 1973 and 2014, five patients developed lung cancer. We analyzed risk factors, transplantation characteristics, treatment options and survival. Results. Lung cancer was diagnosed in 5 patients (0.3%). Time to diagnosis after the transplant procedure ranged from 26 to 156 months (mean 115 months). All of them had a smoking history. Tumors were classified as IIB (20%), IIIA (40%), and IV (40%). Histological types included adenocarcinoma (80%) and there was one case of sarcomatoid carcinoma (20%). One patient had concomitant thyroid papillary carcinoma. Radiotherapy was applied in 2 patients, 2 underwent chemotherapy (erlotinib and combination of carboplatinum and etopozide in one patient each), and 2 died within one month after the diagnosis from disseminated malignant disease. Patients with stage IIIA survived 14 and 24 months after the diagnosis. The patient with sarcomatoid cancer underwent thoracotomy with a complete resection, lost his graft function and died 7 months after the diagnosis. Conclusion. Lung cancer is relatively rare malignancy in renal transplant recipients, but associated with high mortality. Smoking is a significant risk factor, thus smoking cessation should be promoted among renal transplant recipients, as well as regular screening for lung cancer.

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Unexpected Extremely High Level of Creatinine in Non-dialysed Female Patient

References 1. Samra M, Abcar AC. False Estimates of Elevated Creatinine. Perm J 2012; 16: 51-52. 2. Endre ZH, Pickering JW, Walker RJ. Clearance and beyond: the complementary roles of GFR measurement and injury biomarkers in acute kidney injury (AKI). Am J Physiol Renal Physiol 2011; 301: 697-707. 3. Storm AC, Htike NL, Cohen DA, et al. A Surviving Patient with Record High Creatinine. Open Journal of Nephrology 2013; 3: 217-219. 4. Kouba E, Wallen EM, Pruthi RS. Management of ureteral obstruction

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A Rare Outcome Induced by Metformin Intoxication: Severe Lactic Acidosis and Hepatotoxicity

References 1. Aksay E, Yanturali S, Bayram B, et al. A Rare Side Effect of Metformin: Metformin-Induced Hepatotoxicity. Turk J Med Sci 2007; 37 (3): 173-175. 2. Giuliani E, Albertini G, Vaccari C, Barbieri A. pH 6.68-surviving severe metformin intoxication. Q J Med 2010; 103: 887-890. 3. Sencan A, Adanir T, Atay A, et al. High Anion Gap Metabolic acidosis after Suicide: Metformın İntoxication. Anesthesia Journal 2011; 19 (1): 56-59. 4. Heaney D, Majid A and Junor B. Bicarbonate haemodialysis as a

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Kidney Complications Due to Hematopoietic Stem Cell Transplantation-A Disorder of an Increasing Incidence?

References 1. Mohty B, Mohty M. Long-term complications and side effects after allogeneic hematopoietic stem cell transplantation: an update. Blood Cancer J2011; 1:e16; doi:10.1038/bcj.2011.14; published online 29 April 2011. 2. Singh N, McNeely J, Parikh S, et al . Kidney complications of hematopoietic stem cell transplantation. Am J Kidney Dis 2013; 61: 809-821. 3. Martin PJ, Counts Jr GW, Appelbaum FR, et al . Life expectancy in patients surviving more than 5 years after hematopoietic cell transplantation. J Clin Oncol 2010; 28: 1011

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