Special Malignancy Pattern in Chinese Renal Transplantation Recipients: A Single Center Experience and Literature Review

Malignancy is one of the main complications after renal transplantation but the situation in Chinese renal allograft recipients remains an enigma. We therefore reviewed 1,000 (8,531 person-years follow-up) renal allograft recipients from Jinling Hospital, Nanjing University, revealing an incidence rate of 2.4% of post-transplant malignancies, with a standardized incidence ratio (SIR) of 17.8 (95% C.I.: 16.7-18.8); the standardized rate is 1.67%, compared with 0.29% in the general population. However, our group demonstrated an extremely low incidence of skin cancer, which dominates in western countries. To confirm the findings, we reviewed the literature on post-transplant malignancies in Chinese renal allograft recipients, covering 296 malignancies in 18,548 renal transplant recipients in 21 reports. The top three most common sites of malignancies were the digestive tract, bladder and liver. The incidence of skin cancer was very low in most centers. These data show that Chinese renal allograft recipients have a unique spectrum of post-transplant malignancies, with an extremely very low incidence of skin cancer as compared to populations from western countries.