Malignancy Across the Kidney Transplant Continuum: Pre-Transplant Risk, Surveillance, and Post-Transplant Cancer Management

Kidney transplantation is the optimal treatment for end-stage kidney disease, offering substantial gains in survival and quality of life over dialysis. Yet the chronic immunosuppression required to protect the allograft also impairs antitumor immune surveillance, leaving recipients with a two- to threefold higher risk of malignancy than the general population. Cancer is now among the leading causes of death with a functioning graft, accounting for roughly one in five deaths in this population. The spectrum is broad, spanning non-melanoma skin cancers, post-transplant lymphoproliferative disorder, and renal, urological, and gastrointestinal malignancies, and is shaped by oncogenic viruses, cumulative immunosuppressive exposure, donor-transmitted disease, and recipient factors such as older age and prior cancer history. Managing malignancy in immunocompromised recipients, while preserving graft function, remains one of the most complex challenges in transplant medicine.



Despite this growing burden, clinical practice remains hampered by fragmented evidence and a lack of consensus guidelines spanning the full transplant journey. Decisions on accepting candidates with a prior malignancy, defining appropriate cancer-free waiting periods, and assessing donor-derived risk are often made with limited data. After transplantation, the optimal intensity and modality of cancer screening remain undefined, and the management of established malignancy, balancing oncologic efficacy against the risk of rejection and graft loss, is frequently individualized rather than evidence-based. This is especially true for immune checkpoint inhibitors, which are transforming oncology yet carry substantial allograft risk in transplant recipients. This Research Topic aims to consolidate current knowledge and emerging evidence across the entire kidney transplant continuum, from pre-transplant risk stratification, through screening and surveillance, to the treatment of de novo and recurrent cancers. By uniting transplant nephrology, transplant surgery, and oncology perspectives from diverse healthcare systems and donor practices, we seek to inform more consistent, evidence-based decision-making that improves both patient and graft survival.


We welcome Original Research, Reviews, Mini-Reviews, Systematic Reviews, Case Reports, and Perspectives addressing, but not limited to, the following themes:

- pre-transplant cancer risk assessment, eligibility of candidates with prior malignancy, and donor-derived cancer risk

- cancer screening and post-transplant surveillance strategies, and gaps in current guidelines

- incidence, risk factors, and outcomes of de novo and recurrent post-transplant malignancies

- the role of immunosuppressive regimens and drug exposure in promoting or mitigating cancer risk, and immunosuppression modulation during cancer treatment

- clinical decision-making in treating malignancy in immunocompromised recipients, including chemotherapy, radiotherapy, immune checkpoint inhibitors, and locoregional therapies

- the impact of malignancy on death with a functioning graft and long-term graft and patient survival. Contributions offering multidisciplinary, cross-regional, or guideline-oriented perspectives are particularly encouraged

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: kidney transplantation, post-transplant malignancy, cancer screening, immunosuppression, immune checkpoint inhibitors, graft survival, de novo cancer

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.