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Tumors after kidney transplantation: a population study
Giuseppe Ietto1, Mattia Gritti2, Giuseppe Pettinato3
1General, Emergency and Transplant Surgery Department, ASST-Sette Laghi and University of Insubria, Varese, Italy. giuseppe.ietto@gmail.com.
World Journal of Surgical Oncology
|January 23, 2023
Summary
Kidney transplant recipients face a threefold increased cancer risk, particularly for Kaposi's sarcoma and hematological cancers. Post-transplant immunosuppression is a major driver, especially in the early years after transplantation.
Area of Science:
- Nephrology
- Oncology
- Immunology
Background:
- Cancer is a significant cause of morbidity and mortality in kidney transplant recipients.
- Understanding post-transplant neoplastic risk and its determinants is crucial for patient management.
Purpose of the Study:
- To investigate the risk of cancer development in kidney transplant recipients.
- To identify key factors contributing to cancer risk in this population.
Main Methods:
- Analysis of a cohort of 462 renal transplant patients between 2010 and 2020.
- Calculation of standardized incidence ratios (SIR) comparing to the Italian population.
- Extrapolation of absolute risk and attributable fractions for various cancers.
Main Results:
- Kidney transplant recipients exhibit an overall cancer risk approximately three times higher than the general population (SIR 2.8).
- Significantly elevated risks were observed for Kaposi's sarcoma (SIR 195) and hematological cancers (SIR 6.8).
- The risk for Kaposi's sarcoma and hematological cancers was four times higher within the first 3 years post-transplant, with Kaposi's sarcoma diagnoses occurring within 2 years.
Conclusions:
- Post-transplant immunosuppression is strongly linked to Kaposi's sarcoma (99%) and lymphomas (85%).
- Solid tumors account for 39% of post-transplant cancers.
- Data on incidence, immunosuppression contribution, and timing of neoplasms can improve patient follow-up strategies.
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