Kaposi's Sarcoma in a Kidney Transplant Recipient: A Case Report on Paclitaxel Response.

Introduction: In immunocompromised individuals, particularly organ transplant recipients, the risk of developing Kaposi sarcoma (KS) increases significantly due to prolonged immunosuppressive therapy. The onset of post-transplant KS is highly variable, though most cases occur within the first 2 years following transplantation. The effectiveness and safety of systemic therapies, in the management of post-transplant KS are not well established. In this report, we describe a rare case of early-onset KS in a Tunisian kidney transplant recipient, revealed by deep vein thrombosis just 6 months after transplantation and successfully managed with paclitaxel as first-line therapy.

Case presentation: We present the case of a 52-year-old Tunisian male who underwent a living-donor kidney transplant in June 2022. Six months after transplantation, the patient presented with deep vein thrombosis and large purplish plaques were observed on the anterior left thigh. A skin biopsy confirmed the diagnosis of KS. Further Investigations revealed systemic involvement. The patient was treated with paclitaxel-based chemotherapy in combination with sirolimus and a reduction in immunosuppressive therapy. As of November 2024, the patient had demonstrated marked clinical improvement, with resolution of KS lesions and stable renal function.

Conclusion: This case of early-onset KS highlights the potential effectiveness of paclitaxel-based chemotherapy combined with sirolimus and a carefully adjusted reduction in immunosuppressive therapy as a promising first-line treatment option.