Malignancy of Urinary Tract in Kidney Transplant Recipients—A Narrative Review

Kidney transplantation is the optimal treatment for end-stage kidney failure. However, after successful kidney transplantation, patients require long-term immunosuppression. Due to immunosuppressive therapy, the development of malignancies is more common in solid organ transplant recipients than in the general population. Because renal transplantation has been performed for many decades—much longer than other solid organ transplants—data on malignancies in kidney allograft recipients are the most comprehensive. Malignancies are the third most common cause of death in kidney allograft recipients, after cardiovascular disease and infections. In kidney allograft recipients, malignancies may develop de novo, be transmitted with the transplanted organ, or arise from previously present but undiagnosed cancers in the recipient. Over 90% of malignancies in renal allograft recipients are de novo. In this review, we first present the epidemiology of malignancies after kidney transplantation. Subsequently, the most common urinary tract malignancies, along with their diagnosis, treatment, and screening, are discussed. We also outline the limitations of the published data, propose research priorities, and identify existing gaps and unmet needs.