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Risk of cancer in retransplants compared to primary kidney transplants in the U nited S tates
Author(s) -
Kalil Roberto S.,
Lynch Charles F.,
Engels Eric A.
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12601
Subject(s) - medicine , cancer , kidney cancer , dialysis , renal cell carcinoma , panel reactive antibody , kidney transplantation , transplantation , incidence (geometry) , kidney disease , poisson regression , kidney , urology , surgery , population , physics , environmental health , optics
Recipients of kidney transplantation have elevated risk of developing cancer. There are limited data on cancer risk in recipients of kidney retransplantation. We used data from the Transplant Cancer Match Study, which links the U.S. transplant registry with 15 cancer registries. Cancer incidence in recipients of kidney retransplantation and primary kidney transplants was compared utilizing Poisson regression, adjusting for demographic and medical characteristics. We assessed 109 224 primary recipients and 6621 retransplants. Compared to primary recipients, retransplants were younger (median age 40 vs. 46 yr), had higher PRA , and more often received induction with polyclonal antibodies (43% vs. 25%). A total of 5757 cancers were observed in primary recipients and 245 in retransplants. Overall cancer risk was similar in retransplants compared with primary recipients (incidence rate ratio [ IRR ] 1.06, 95% CI 0.93–1.20, adjusted for age, gender, race/ethnicity, PRA , and use of polyclonal induction). However, renal cell carcinoma ( RCC ) occurred in excess among retransplants (adjusted IRR 2.03, 95% CI 1.45–2.77), based on 514 cases in primary recipients and 43 cases in retransplants. Overall cancer risk did not differ in retransplants compared to primary recipients. Increased risk of RCC may be explained by the presence of acquired cystic kidney disease, which is more likely to develop with additional time with kidney disease and time spent on dialysis waiting for retransplantation.