Elsevier

Transplantation Proceedings

Volume 47, Issue 9, November 2015, Pages 2618-2621
Transplantation Proceedings

9th Congress of the Andalucian Transplantation Society
Kidney transplantation
Incidence and Long-Term Prognosis of Cancer After Kidney Transplantation

https://doi.org/10.1016/j.transproceed.2015.08.043Get rights and content

Abstract

Background

Malignancy is an important cause of mortality in renal transplants recipients. The incidence of cancer is increased by immunosuppressive treatment and longer kidney graft survival. The aim of this study was to evaluate the incidence, prognosis and survival of posttransplant malignancies: solid organ cancer (SOC), posttransplant lymphoproliferative disorder (PTLD), and nonmelanoma skin cancer (NMSC).

Methods

We retrospectively studied the development of cancers among kidney transplants patients in our hospital from January 1979 to January 2015. We analyzed demographic and clinical characteristics, risk factors, and patient survival after tumor diagnosis.

Results

We included 1450 kidney transplants recipients with a mean follow-up was 10 years; among them, 194 developed malignancies. The mean age at presentation was 59 ± 10 years. The SOC, PTLD, and NMSC incidences were 6.2%, 1.2%, and 6%, respectively. The most common tumors were kidney (16.6%), colon (11%), bladder (10%), breast (10%), prostate (10%), and lung (8.8%). The median times to development of a SOC, PTLD, and NMSC were 6.86 (range, 3.7–12), 4.43 (range, 1.8–5.7), and 8.19 (range, 3.8–12.2) years, respectively. Risk factors associated with developing SOC and PTLD were patient age (odds ratio [OR], 1.03; P < .001) and time posttransplant (OR, 1.05; P = .02), whereas for NMSC were to be male (OR, 3.61; P < .001), to take calcineurin inhibitors (OR, 2.17; P = .034), patient age (OR, 1.05; P < .001) and time posttransplant (OR, 1.15; P < .01). The mean survival time from the diagnosis of SOC, PTLD, and NMSC were 2.09 (range, 0.1–5.3), 0.22 (range, 0.05–1.9), and 7.68 (range, 3.9–10.5) years, respectively (P < .001).

Conclusions

SOC occurs more frequently than other malignancies among renal transplant patients. NMSC has better survival and prognosis. Older patients and prolonged graft function have a greater risk of developing malignancies.

Section snippets

Selection and Description of Participants

We retrospectively analyzed the development of de novo cancers among our population of kidney transplants recipients from January 1979 to January 2015. All transplanted patients were followed at our outpatient care unit as long as their transplanted kidney functioned. In case of complication, they were admitted to our department. Patient data and posttransplantation complications were registered in our database. Transplanted patients received triple immunosuppressive therapy with

Patient Characteristics and Clinical Variables

There were 1450 renal transplantations performed in our hospital between January 1979 and January 2015 (1424 from deceased donors and 26 from living donors). A total of 178 were combined transplants (164/178 pancreas–kidney transplantation). The mean follow-up was 10 years.

We studied 194 transplanted patients who developed SOC, PTLD, or NMSC. Most transplant patients with cancer were male (74%) and showed a mean age at presentation of 59 ± 10 years. Patient's demographics and clinical

Discussion

The problem of de novo tumors developing after kidney transplantation is progressively growing. It is owing to increased age of the transplanted population and the long-term immunosuppressive therapy [15], [16], [17]. In addition, malignancy represents an important cause of mortality after renal transplantation; it is the third leading cause of death in Spain and the United States, and the second leading cause in Australia [18].

In our study, we analyzed a kidney transplant cohort of 194

References (18)

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