在HLA不兼容的活体捐赠者脏移植后,癌症风险
Jennifer D Motter1, Allan B Massie1,2, Jacqueline M Garonzik-Wang3
1Department of Surgery, New York University Grossman School of Medicine, New York, NY.
Transplantation direct
|July 26, 2023
概括
与相容接受者相比,接受了不兼容的活体供体移植的脏移植受体的癌症风险并不高. 需要进一步的研究,以了解潜在的,虽然不是统计学意义上的,增加结直肠癌风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 移植免疫学 移植免疫学
- 在瘤学瘤学.
背景情况:
- 与不兼容捐赠者的移植接受者 (ILDKTr) 需要脱敏治疗.
- 这种免疫抑制可能会增加严重并发症的风险,包括癌症.
研究的目的:
- 评估和比较ILDKTr中的癌症风险与相容的活体捐赠移植接受者 (CLDKTr) 的癌症风险.
主要方法:
- 一项多中心队列研究从1997年至2016年评估了858个ILDKTr和12239个CLDKTr.
- 癌症发病率与美国移植和33个癌症登记簿有关.
- 使用权重考克斯回归来比较癌症发病率.
主要成果:
- 整体侵袭性癌症发生率相似:ILDKTr中的6.2%,CLDKTr中的6.6% (wHR1.01;95% CI,0.76-1.35).
- 基础细胞和状细胞癌的发病率也相似:ILDKTr中的4.8%,CLDKTr中的6.0% (wHR 0.99;95% CI,0.69-1.40).
- 一项探索性分析表明,ILDKTr中结直肠癌的风险较高 (wHR 3.27;95% CI,1.23-8.71),但在多次比较校正后,这在统计学上并不重要.
结论:
- 来自不兼容的活体捐赠者的移植与相容的捐赠者相比,似乎没有增加整体癌症风险.
- 无法解释的,不显著的结直肠癌风险升高需要进一步调查.
- 针对ILDKTr,可以考虑量身定制的查或预防策略.
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