Figure 122

Screening for cancer. An active malignancy is an absolute contraindication to transplantation. Effective screening measures for patients at risk include chest radiograph, mammogram, PAP test, stool Hemoccult, digital rectal examination, and flexible sigmoidoscopy examination. Patients who have had a life-threatening malignancy but are potentially cured may be candidates for transplantation when there has been an appropriate disease-free interval. This interval generally is at least 2 years, and longer in the case of some malignancies. (From Kasiske and coworkers [1].)

Active infection?

Screening for infection in recipients " Yes

Appropriate treatment and disease-free interval

HIV positive?" No^

History of TB or positive PPD without adequate therapy?

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