Difference in renal cell carcinoma (RCC) prevalence between kidney transplant versus other solid organ transplant patients.
Authors: Warraich Kainat , Briggs Logan , Choudry Mouneeb , Jeffery Jaxson R , Ghaffar Umar , Nica Alex S , Carr Declan , Channar Aneeta , Khan Muhammad Ali , Singh Parminder , Zakharia Yousef , Riaz Irbaz Bin , Abdul-Muhsin Haidar 
Published: February 2025

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Background:
The annual incidence of renal cancer is 0.02% among the general United States population. End stage renal disease (ESRD) and exposure to dialysis are thought to be the primary drivers of increased risk of renal cancer in renal transplant patients rather than immunosuppression. This has been evidenced by how the incidence of RCC in heart transplant recipients is no different than the normal population. In this study, we aim to characterize RCC incidence among kidney transplant patients (usually exposed to ESRD/dialysis) versus other solid organ transplant patients (usually unexposed to ESRD/dialysis).
Methods:
We used CPT codes to search for patients who had received a solid organ transplant (kidney, liver, heart, lung, pancreas) at all Mayo Clinic sites from 1/1/2018 to 1/1/2024. Within this cohort, we identified those who had been diagnosed with kidney cancer after initiating dialysis or receiving a transplant, and retrospectively extracted data related to demographics, cancer diagnosis, and transplant details.
Results:
We identified 10873 patients who had received a solid organ transplant (Table 1). Of these, 178 (1.76%) were diagnosed with kidney cancer after either starting dialysis or receiving a transplant. These 178 patients were of median age 56 years at time of cancer diagnosis (STD 12), 71% male, 70% white, 20% black, 4.5% Asian, 2.8% American Native. Of 5792 patients who had received a kidney transplant (with or without another solid organ transplant), 172 (2.97%) were diagnosed with kidney cancer after having started dialysis or receiving a kidney transplant. Of these 172, 156 (91%) were exposed to dialysis (107 primarily hemodialysis and 48 peritoneal). Of 4392 patients who had received a solid organ transplant other than kidney (liver, heart, lung, and/or pancreas), 6 (0.14%) were diagnosed with kidney cancer after having received a kidney transplant. Of these 6, none underwent dialysis.
Conclusions:
Patients with kidney transplants are at increased risk of kidney cancer compared to patients with non-kidney solid organ transplants (2.97% vs 0.14%). This supports prior evidence showing ESRD plays a significant role in the pathogenesis of kidney cancer.

Patients who received solid organ transplants at Mayo Clinic from 2018-2024 and were subsequently diagnosed with kidney cancer.

n

%

With RCC after TXP
178
1.7587%

Cancer Diagnosis after Kidney HD/TXP
172
2.9696%

Cancer Diagnosis after Other TXP
6
0.1386%

Patients who received solid organ transplants at Mayo Clinic from 2018-2024

n

%

Unique Patients
10121
100%

Kidney Transplant
5792
57.23%

Alone
5088
50.27%

&Liver
332
3.28%

&Heart
119
1.18%

&Lung
8
0.08%

&Pancreas
245
2.42%

Non-kidney Transplant (Liver, Heart, Lung, or Pancreas)
4329
42.77%

TXP: Transplant, HD: Hemodialysis.