Risk of malignancy with long-term immunosuppression in renal transplant recipients

Mahendra L. Agraharkar, Robert D. Cinclair, Yong Fang Kuo, John A. Daller, Vahakn B. Shahinian

Research output: Contribution to journalArticle

81 Citations (Scopus)

Abstract

Background. Improvements in immunosuppressive regimens have significantly enhanced patient and graft survival in renal transplant recipients. However, susceptibility to neoplastic disorders is increased as a consequence of prolonged immunosuppression. Available data pertaining to cancer risks in renal transplant recipients have been inconsistent, and much of it is derived from international studies, which may not be truly representative of the United States population. Methods. We studied a total of 1979 transplants performed in 1739 patients from a single center in the United States with a mean follow-up of 6.1 years, and a total of 9852 person-years' follow-up. Results. The mean age at the time of diagnosis of cancer was 50 years, and the mean interval between transplant and diagnosis of cancer was 95 months. Older patients receiving a transplant had a significantly higher risk for developing cancer as opposed to younger patients (RR 6.2 for >60 years compared with <40 years). When compared with the general population using data from the Surveillance, Epidemiology and End Results (SEER) registry, the overall risk for nonskin malignancies was modestly increased in our transplant recipients, with a standardized incidence ratio (SIR) of 1.4 (P = 0.01). When stratified by age groups, younger age at transplant (<40 years) had the highest SIR, at 2.3 (P < 0.001). Similarly, duration post-transplant >10 years had an SIR of 2.4 (P < 0.001). Conclusion. We believe that this study is representative of the United States' renal transplant population, and highlights the need for reduced immunosuppression in the long-term and increased vigilance for cancers in younger patients receiving renal transplantation.

Original languageEnglish (US)
Pages (from-to)383-389
Number of pages7
JournalKidney International
Volume66
Issue number1
DOIs
StatePublished - Jul 2004
Externally publishedYes

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Immunosuppression
Kidney
Transplants
Neoplasms
Graft Survival
Immunosuppressive Agents
Kidney Transplantation
Population
Transplant Recipients

Keywords

  • Cancer risk
  • Imunosuppression
  • Kidney transplantation
  • Post-transplant neoplasms

ASJC Scopus subject areas

  • Nephrology

Cite this

Risk of malignancy with long-term immunosuppression in renal transplant recipients. / Agraharkar, Mahendra L.; Cinclair, Robert D.; Kuo, Yong Fang; Daller, John A.; Shahinian, Vahakn B.

In: Kidney International, Vol. 66, No. 1, 07.2004, p. 383-389.

Research output: Contribution to journalArticle

Agraharkar, Mahendra L. ; Cinclair, Robert D. ; Kuo, Yong Fang ; Daller, John A. ; Shahinian, Vahakn B. / Risk of malignancy with long-term immunosuppression in renal transplant recipients. In: Kidney International. 2004 ; Vol. 66, No. 1. pp. 383-389.
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