New horizons in transplantationKidney transplantationManagement of Bladder Cancer After Renal Transplantation

- Bladder cancers may occur with higher incidence in the renal transplant population and may be more likely to present as muscle-invasive disease.
- Technical difficulties occur in patients with a graft who have had prior surgery and are diagnosed with muscle-invasive bladder cancer that requires radical cystectomy as part of the treatment.
- Radical cystectomy with pelvic lymphadenectomy and ileal conduit is useful treatment for bladder cancer in renal transplant recipients.
- There are few studies focused on management of bladder cancer in this patient group.

ObjectivesIn renal transplant recipients, the risk of developing bladder cancer and rate of diagnosis of advanced staged bladder cancer are generally higher than the general population. Also, it is more challenging to treat renal transplant recipients than the regular patient population. We aimed to evaluate the efficacy and safety of radical cystectomy (RC) and urinary diversion with ileal conduit in renal transplant recipients.MethodsWe identified 2 patients with prior history of renal transplantation who underwent RC and ileal conduit urinary diversion for bladder cancer. Preoperative clinical and demographic data were presented and outcomes were assessed.ResultsThe RC and ileal conduit urinary diversion were performed in the first patient 56 months after renal transplantation and in the second patient 64 months after renal transplantation. Clinical staging was high-grade T2 transitional cell cancer of the bladder for patient 1 and T2 with pure squamous cell cancer of the bladder for patient 2. No perioperative or postoperative complication and no graft dysfunction occurred in either patient.ConclusionOur experience demonstrated that RC with ileal conduit reconstruction in renal transplant recipients is safe and feasible.