Original Works: Case ReportsKidneyDonor-Derived Metastatic Melanoma and Checkpoint Inhibition

- Donor-derived melanoma is a rare but known complication of kidney transplantation.
- Checkpoint inhibitor therapy and targeted therapy are novel interventions for metastatic melanoma that significantly improve disease survival.
- Checkpoint inhibitor therapy and targeted therapy can be safely used in donor-derived melanoma in dialysis-dependent patients.

Donor-derived malignancy, particularly melanoma, is a rare but known complication of organ transplantation. Here we describe a case of metastatic melanoma in a deceased-donor kidney transplant recipient. After diagnosis, the patient was successfully treated with cessation of immunosuppression, explantation of the renal allograft, and novel melanoma therapies, including the mutation-targeted agents dabrafenib and trametinib and the immune checkpoint inhibitor nivolumab. These 2 new classes of melanoma therapy have revolutionized the course of metastatic melanoma, altering it from one of nearly certain mortality to one of potential cure. This case reviews the mechanisms of action of these therapies and reports our experience with them in the rare setting of donor-derived melanoma in a dialysis-dependent patient.