Evidence map›Paper›PMID 38847938›Full record

ArticleJournal of nephrology2024

High malignancy rate in the absence of viral prophylaxis after kidney transplantation in Sudan.

Sarra Elamin, Selma S Ibrahim, Hatim Mudawi, Sara E A Mohamed Ali, Ali Abdel-Satir, Ayman F A Foad

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Article in Journal of nephrology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Sarra ElaminDoctor Selma Center for Kidney Diseases, University of Khartoum, Khartoum, Sudan. sarraelamin@hotmail.com.ORCID 0000-0002-1490-7477
Selma S IbrahimDoctor Selma Center for Kidney Diseases, University of Khartoum, Khartoum, Sudan.
Hatim MudawiGastroenterology Unit, Soba University Hospital, University of Khartoum, Khartoum, Sudan.
Sara E A Mohamed AliGastroenterology Unit, Soba University Hospital, University of Khartoum, Khartoum, Sudan.
Ali Abdel-SatirHistopathology Department, Histo Center, Khartoum, Sudan.
Ayman F A FoadHistopathology Department, National University, Khartoum, Sudan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundKidney transplantation in Sudan is funded by the government. Cytomegalovirus prophylaxis is provided for patients who receive biological induction or have recipient-negative donor-positive cytomegalovirus serology. Doctor Selma Center for Kidney Diseases joined the national kidney transplant program in May 2019. Since then, we observed the frequent occurrence of cancer in patients who received modest immunosuppression without viral prophylaxis.

methodsWe retrospectively divided kidney transplant recipients between 2019 and 2021 into two groups according to cytomegalovirus prophylaxis and compared tumor occurrence rates.

resultsThe first group included 77 patients who did not receive biological induction or cytomegalovirus prophylaxis. The second group included 92 patients who received valganciclovir for 3-6 months. There was no other antiviral treatment except entecavir for chronic hepatitis B virus infection in eight patients. Five patients in the first group developed malignancy. The first patient presented eight months post-transplant with Kaposi sarcoma of the stomach and responded to treatment with sirolimus. The second patient presented nine months post-transplant with cutaneous Kaposi sarcoma and also responded to sirolimus. Two patients presented two and four months post-transplant with aggressive non-cutaneous Kaposi sarcoma that involved the gastrointestinal tract and lymphatic system and died soon afterwards. The fifth patient presented three years post-transplant with non-Hodgkin lymphoma of the duodenum and is currently receiving chemotherapy. Malignancy rate (6.5% vs 0.0%, P = 0.02) and Kaposi sarcoma rate (5.2% vs 0.0%, P = 0.04) were significantly higher in the first group.

conclusionIn Sudan, omitting valganciclovir prophylaxis after kidney transplantation was associated with a high rate of virus-induced malignancy.

Indexed as

Antiviral AgentsCytomegalovirus InfectionsKidney TransplantationValganciclovirAdultFemaleHumansImmunosuppressive AgentsMaleMiddle AgedNeoplasmsRetrospective StudiesSarcoma, KaposiSudanAntiviral AgentsImmunosuppressive AgentsValganciclovirEpstein Barr virus (EBV)Kaposi sarcomaKaposi sarcoma herpes virus (KSHV)Kidney transplantNon-Hodgkin lymphomaSudanValganciclovirVirus-induced malignancy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.