Abstract
Kaposi sarcoma (KS) is an angioproliferative neoplasm linked to human herpesvirus-8 (HHV-8) and occurs more frequently in immunosuppressed patients, including kidney transplant recipients. While KS typically manifests cutaneously, visceral disease represents an uncommon presentation. Visceral KS involving the allograft kidney in patients with a previous renal transplant is an exceedingly rare finding that has seldom been reported. Herein, we report the case of a 66-year-old man with a history of kidney transplant who was found to have biopsy-confirmed, HHV-8-positive visceral KS involving the renal allograft less than one year post transplant, without cutaneous involvement. The patient's clinical course was marked by severe vasculature obstruction, bowel ischemia, and sepsis as a result of his disease burden, culminating in death despite prompt withdrawal of immunosuppression, highlighting the rarity and severity of allograft-associated KS. The severe manifestations of this patient's disease underscore the need for heightened vigilance when treating our immunosuppressed population to ensure appropriate and prompt care is given.