Cancer rates after kidney transplantation

Previous studies demonstrated a 3-5-fold increased cancer risk in kidney allograft recipients compared with the general population. Our aim was to estimate cancer frequencies among kidney allograft recipients who were transplanted in 1997-2000 and who were immunosuppressed according to a more modern steroid-free standard protocol based on basixilimab, ciclosporine and mycophenolate mofetil.

This was a retrospective cohort study of patients receiving their first kidney allograft in 1997-2000 at Odense University Hospital, Denmark (n = 90). Histologically verified cancers were identified from a detailed search of the individual patient's medical records.

During an average follow-up time of 8.4 years, a total of 14 cancers were observed. The cancer incidence rate was 18.5 (95% confidence interval (CI): 11.0-31.3) per 1,000 years, and the cancer prevalence was 13.4% (95% CI: 5.6-21.2%) among survivors in 2007. The relative risk of prevalent cancer was 3.6 (95% CI: 2.0-6.5) compared with the general population. Patients with cancer had a poorer survival than patients without cancer.

The observed cancer incidence rate and prevalence were similar to figures derived from studies performed in the earlier eras of kidney transplantation. Reducing cancer rates after kidney transplantation remains an important challenge for nephrologists.

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