Answer to Question #196 Submitted to "Ask the Experts"

Q

What are the effects of ionizing radiation on someone with a kidney transplant, given the person is on immune suppression drugs and his organ is closer to the skin and has had a lot of x rays during his lifetime?

A

Presumably this question deals with low-dose radiation, such as from diagnostic medical or environmental sources. Organ transplants in general, and kidney transplants in particular, pose no special risk for these exposures. If the question deals with high doses, such as those used for treatment of cancer in radiation oncology, then management of current (life-threatening) disease would take precedence over the risk of a delayed radiation effect. The kidney is not very sensitive to radiation. Deterministic effects, including nephrosclerosis and hypertension, occur months to years after large doses. Stochastic effects, i.e., cancer, have not been specifically detected from smaller doses. In Japanese atomic bomb survivors, there was excess bladder cancer and total urinary tract cancer was elevated. There was no separate analysis for kidney cancer. Numerous studies following medical or occupational exposure failed to detect a statistically significant elevation in kidney cancer. Conclusion: radiation risk is not significantly altered in kidney transplant patients. S. Julian Gibbs, DDS, Ph.D., Professor of Radiology