Case Presentation: Regression of Kaposi’s Sarcoma in a Sudanese kidney Transplant Recipient after Conversion to Sirolimus: a Focus on a Common Clinical Problem

Abstract

Introduction: Post-transplant malignancy is an increasing problem among patients receiving solid organ transplant worldwide. It has been related to recipient morbidity and mortality. Kaposi's sarcoma (KS) is a relatively common malignancy after kidney and solid organ transplantation, accounting for the majority of malignancies among those patients in developing countries.
Case report: We report a 56-year-old male who underwent pre-emptive kidney transplantation on July 2010 from a live related donor (LRD), his son, with an HLA mismatch of three antigens. Induction with Basiliximab (Simulect) was given at the time of transplantation and the patient was then maintained on prednisolone, cyclosporine and azathioprine. He had an episode of acute rejection treated with pulses of methyl prednisolone. Three months after transplantation he presented with Kaposi’s sarcoma of the skin, the diagnosis of which was confirmed by histological examination. Immunosuppressant medication was switched to sirolimus and mycophenolate mofetil. He showed good response within two months of treatment with regression of the skin lesions and improvement of his renal function.
Conclusion: Kaposi sarcoma can occur shortly after transplantation in men of African descent. This report confirms earlier reports about the beneficial effect of sirolimus in regression of KS lesions.

Keywords: Kaposi’s sarcoma; Kidney Transplantation; Sirolimus; Sudan