Malignancy in Kidney Transplantation: A 25-Year Single-center Experience in Portugal

Aguiar, Brigite; Amorim, T. Santos; Romãozinho, Catarina; Santos, Lídia; Macário, Fernando; Alves, Rui; Campos, Mário; Mota, A.

doi:10.1016/j.transproceed.2015.03.039

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…Previous studies reported a higher incidence of cancer, with a 20‐year cumulative incidence of cancer (including nonmelanoma skin cancer) approaching as high as 60% in adult transplant recipients . The lower cumulative incidence of cancer in those who received a kidney transplant during childhood was expected, as increasing age at transplantation has been associated with increased cancer risk . This study further confirms findings from previous observational studies.…”

Section: Discussionsupporting

confidence: 89%

Incidence and Predictors of Cancer Following Kidney Transplantation in Childhood

Francis

Johnson

Craig

et al. 2017

American Journal of Transplantation

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Cancer risk is increased substantially in adult kidney transplant recipients, but the long-term risk of cancer in childhood recipients is unclear. Using the Australian and New Zealand Dialysis and Transplant Registry, the authors compared overall and site-specific incidences of cancer after transplantation in childhood recipients with population-based data by using standardized incidence ratios (SIRs). Among 1734 childhood recipients (median age 14 years, 57% male, 85% white), 289 (16.7%) developed cancer (196 nonmelanoma skin cancers, 143 nonskin cancers) over a median follow-up of 13.4 years. The 25-year cumulative incidences of any cancer were 27% (95% confidence intervals 24-30%), 20% (17-23%) for nonmelanoma skin cancer, and 14% (12-17%) for nonskin cancer (including melanoma). The SIR for nonskin cancer was 8.23 (95% CI 6.92-9.73), with the highest risk for posttransplant lymphoproliferative disease (SIR 45.80, 95% CI 32.71-62.44) and cervical cancer (29.4, 95% CI 17.5-46.5). Increasing age at transplantation (adjusted hazard ratio [aHR] per year 1.10, 95% CI 1.06-1.14), white race (aHR 3.36, 95% CI 1.61-6.79), and having a functioning transplant (aHR 2.27, 95% CI 1.47-3.71) were risk factors for cancer. Cancer risk, particularly for virus-related cancers, is increased substantially after kidney transplantation during childhood.

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Section: Discussionsupporting

confidence: 89%

Incidence and Predictors of Cancer Following Kidney Transplantation in Childhood

Francis

Johnson

Craig

et al. 2017

American Journal of Transplantation

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“…Age at and time of diagnosis of GIT after KT are in line with earlier publications [40]. Survival after colorectal cancer depends significantly on the stage of disease but is generally poor after SOT and worse compared to the general population [5,[40][41][42]. This fact is underlined by the present investigation.…”

Section: Specific Cancers and Their Epidemiological Analysessupporting

confidence: 91%

De-novo malignancies after kidney transplantation: A long-term observational study

et al. 2020

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Background De-novo malignancies after kidney transplantation represent one major cause for mortality after transplantation. However, most of the studies are limited due to small sample size, short follow-up or lack of information about cancer specific mortality. Methods This long-term retrospective analysis included all adult patients with complete follow-up that underwent kidney transplantation between 1995 and 2016 at our centre. All patients with diagnosis of malignancy excluding non-melanoma skin cancer (NMSC) were identified and a matched control group was assigned to the kidney transplant recipients with post-transplant malignancies. Results 1417 patients matched the inclusion criteria. 179 malignancies posttransplant were diagnosed in 154 patients (n = 21 with two, n = 2 patients with three different malignancies). Mean age at cancer diagnosis was 60.3±13.3 years. Overall incidence of de-novo malignancies except NMSC was 1% per year posttransplant. Renal cell carcinoma was the most common entity (n = 49, incidence 4.20 per 1000 patient years; cancer specific mortality 12%), followed by cancer of the gastro-intestinal tract (n = 30, 2.57; 50%), urinary system (n = 24, 2.06; 13%), respiratory system (n = 18, 1.54; 89%), female reproductive system (n = 15, 1.29; 13%), posttransplant lymphoproliferative disorders and haematological tumours (n = 14, 1.20; 21%), cancers of unknown primary (n = 7, 0.60 100%) and others (n = 22, 1.89; 27%). Male sex, re-transplantation and time on dialysis were associated with de-novo malignancies after transplantation. Conclusion De-novo malignancies continue to be a serious problem after kidney transplantation. To improve long-term outcome after Kidney transplantation, prevention and cancer screening should be more tailored and intensified.

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“…High sCD30, as a Th2 marker, may reflect the risk of these complications, which is supported by the literature [24, 56]. The association of higher pretransplant sCD30 with increased frequency of early AR can also be taken into account, because AR itself is an independent risk factor for malignancy and coronary heart disease after kidney transplantation [2, 3]. …”

Section: Discussionmentioning

confidence: 67%

“…However, death with functioning graft and chronic renal allograft dysfunction are the major obstacles to improve outcomes after kidney transplantation [1]. Infections, cardiovascular diseases, and cancer are the major causes of death with functioning graft [2–4], whereas acute rejection (AR) and impairment of initial kidney allograft function are among the major risk factors of chronic renal allograft dysfunction [5–7]. Thus, there is an urgent need to develop the reliable biomarkers to identify patients at higher risk of premature death or allograft loss.…”

Section: Introductionmentioning

confidence: 99%

Peritransplant Soluble CD30 as a Risk Factor for Slow Kidney Allograft Function, Early Acute Rejection, Worse Long-Term Allograft Function, and Patients’ Survival

Trailin

Ostapenko²,

Nykonenko

et al. 2017

Disease Markers

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Background We aimed to determine whether serum soluble CD30 (sCD30) could identify recipients at high risk for unfavorable early and late kidney transplant outcomes. Methods Serum sCD30 was measured on the day of kidney transplantation and on the 4th day posttransplant. We assessed the value of these measurements in predicting delayed graft function, slow graft function (SGF), acute rejection (AR), pyelonephritis, decline of allograft function after 6 months, and graft and patient survival during 5 years of follow-up in 45 recipients. Results We found the association between low pretransplant serum levels of sCD30 and SGF. The absence of significant decrease of sCD30 on the 4th day posttransplant was characteristic for SGF, early AR (the 8th day–6 months), late AR (>6 months), and early pyelonephritis (the 8th day–2 months). Lower pretransplant and posttransplant sCD30 predicted worse allograft function at 6 months and 2 years, respectively. Higher pretransplant sCD30 was associated with higher frequency of early AR, and worse patients' survival, but only in the recipients of deceased-donor graft. Pretransplant sCD30 also allowed to differentiate patients with early pyelonephritis and early AR. Conclusions Peritransplant sCD30 is useful in identifying patients at risk for unfavorable early and late transplant outcomes.

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Malignancy in Kidney Transplantation: A 25-Year Single-center Experience in Portugal

Cited by 12 publications

References 16 publications

Incidence and Predictors of Cancer Following Kidney Transplantation in Childhood

Incidence and Predictors of Cancer Following Kidney Transplantation in Childhood

De-novo malignancies after kidney transplantation: A long-term observational study

Peritransplant Soluble CD30 as a Risk Factor for Slow Kidney Allograft Function, Early Acute Rejection, Worse Long-Term Allograft Function, and Patients’ Survival

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