Donor-Derived Metastatic Urothelial Carcinoma

Renal transplantation continues to be the best therapeutic option for patients with end stage renal disease (ESRD), reaping the benefits of improved mortality and quality of life, despite the risks involved with chronic immunosuppression. Post-transplant management typically includes monitoring of malignancies, as they carry significant morbidity and mortality. Most post- transplant malignancies that develop are de novo in origin, originating from the recipient. In contrast, donor-derived malignancies are exceedingly rare. We describe a unique case of donor derived metastatic urothelial carcinoma who underwent complete cancer remission following transplant nephrectomy and withholding immunosuppression, in the absence of any chemotherapy.