Post-Transplant Thyroid Cancer IS Reduction — ESENeph MCQ
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Correct answer: B — Individualise immunosuppression reduction with transplant-oncology input
The best answer is “Individualise immunosuppression reduction with transplant-oncology input”. KDIGO suggests considering immunosuppression reduction in transplant recipients with malignancy. The cancer prognosis, planned therapy, rejection risk and drug interactions determine which agents and doses change. “Stop all therapy immediately without a graft-risk plan” is less appropriate because abrupt cessation risks rejection and sensitisation “Increase mycophenolate to enhance tumour control” is less appropriate because greater immunosuppression does not treat the malignancy “Leave every drug unchanged because the cancer type makes review unnecessary” is less appropriate because malignancy prompts an individual risk-benefit review “Replace oncological treatment with dialysis” is less appropriate because dialysis does not treat papillary thyroid cancer
Reference: KDIGO kidney transplant recipient guideline: https://kdigo.org/wp-content/uploads/2022/09/KDIGO-2009-Transplant-Recipient-Guideline-English.pdf