肾移植是大多数肾衰竭患者的最佳治疗方法。对于既往有癌症治疗史的患者，列出和移植资格的决定是复杂的。患者和卫生专业人员有义务考虑癌症治愈和移植之间的时间间隔、免疫抑制影响下癌症复发的风险以及疾病复发时的抗癌治疗方案。癌症复发与高死亡率相关，因此可能会降低移植的预期生存效益，并抑制稀缺器官的利用。鉴于伤害风险的不确定性，临床医生只有在较长时间的无癌间隔后才会考虑对有癌症病史的候选人进行移植，因为对疾病复发和预期寿命缩短的恐惧可能超过接受肾移植的好处。与透析。在过去的十年中，新型抗癌疗法的发展加上对癌症基因组学了解的加深，使无癌生存率得到了显着改善。因此，根据癌症生物学、可用治疗方案和临床结果的预后协变量的共同影响，做出个体化的移植适宜性决策是合理的。在这篇综述中，我们首先总结了肾移植受者的癌症流行病学。然后，我们探讨了癌症治愈的可能性、复发风险和有癌症病史的候选人的结果如何影响移植决定。最后，讨论了卫生专业人员和患者之间关于最佳管理方案的共同决策的作用，以及对患者偏好和价值观的考虑。© 作者 2023。由牛津大学出版社代表 ERA 出版。

Kidney transplantation is the optimal treatment for most patients with kidney failure. For patients with a prior history of treated cancers, listing and transplant eligibility decisions are complex. Patients and health professionals are obliged to consider the time-periods between cancer cure and transplantation, the risk of cancer recurrence under the influence of immunosuppression and anti-cancer treatment options if the disease recurs. Cancer recurrence is associated with a high mortality rate, thus potentially reduces the projected survival benefit of transplantation, and dampens the utility of scarce organs. In view of the uncertain risk of harms, clinicians may consider transplantation for candidates with prior cancer history only after an extended period of cancer-free interval, as the fear of disease recurrence and shortened life expectancy may outweigh the benefits of receiving a kidney transplant compared with dialysis. Over the past decade, the evolution of novel anti-cancer therapies coupled with improved understanding of cancer genomics have led to considerable improvement in cancer-free survival. It is therefore justifiable to make individualized transplant suitability decisions based the joint effects of cancer biology, available therapeutic options and prognostic covariates on clinical outcomes. In this review, we first summarized the cancer epidemiology in kidney transplant recipients. We then explored how the probability of cancer cure, risk of recurrence and outcomes in candidates with a prior cancer history may influence the decisions to transplant. Finally, the role of shared decision-making between health professionals and patients regarding the optimal management options, and considerations of patients' preferences and values are discussed.© The Author(s) 2023. Published by Oxford University Press on behalf of the ERA.