Ces Urol 2024, 28(1):22-29 | DOI: 10.48095/cccu2024010

New perspectives in patients with prostate cancer before and after kidney transplantation

Pavel Navrátil^{1, 2, 3}, Ivo Novák^{1, 3}, Jaroslav Pacovský^{1, 2, 3}, Pavel Navrátil st.^{1, 2, 3}

¹ Urologická klinika, FN Hradec Králové

² Univerzita Karlova, Lékařská fakulta v Hradci Králové

³ Mezioborové transplantační centrum, FN Hradec Králové

Navrátil P, Novák I. Pacovský J, Navrátil P st. New perspectives in patients with prostate cancer before and after kidney transplantation. Over recent decades, there has been a significant increase in patients treated for end-stage renal disease diagnosed with prostate cancer before kidney transplantation, as well as an increase in kidney transplant recipients diagnosed with prostate cancer. Pre-transplant screening, the aging population, and extended survival post-transplant play a role. New insights lead to adjustments in some diagnostic and therapeutic procedures in this patient group, yet clear recommended guidelines remain absent. Also, patients with low-risk prostate cancer in active surveillance or after curative therapy are no longer required to wait before being listed for transplantation. Special attention is given to the role of immunosuppressive therapy, which is essential for the function of the transplanted kidney but may also influence the risk and course of oncological disease. Modifying or reducing immunosuppression, as suggested by current literature, may be a reasonable step in some cases but requires careful consideration in the context of the individual patient. Patients who have undergone kidney transplantation and are diagnosed with prostate cancer achieve similar treatment outcomes as patients with no end-stage renal disease. In the text, we summarize current knowledge regarding epidemiology, treatment options, and challenges faced by medicine in patients with prostate cancer before and after kidney transplantation, including their differences from the general population.

Keywords: Prostate cancer, kidney transplantation, waiting list .

Received: March 11, 2024; Revised: April 4, 2024; Accepted: April 10, 2024; Prepublished online: April 15, 2024; Published: May 2, 2024