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Kidney transplants may increase cancer incidence and mortality risk

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Eric H.K. Au

SAN DIEGO — During periods with a functional kidney transplant, patients have an increased cancer incidence and mortality risk, according to data presented at ASN Kidney Week 2018.

“I think it’s important to understand the greatly increased risk of cancers in patients after they've received a transplant,” Eric H.K. Au, BSc (Med) Hons, MBBS (Hons), MPH, FRACP, of the University of Sydney, said at the meeting.

Au and colleagues selected patients from the Australian and New Zealand Dialysis and Transplant Registry and followed all Australian patients who commenced renal replacement therapy between 1982 and 2014 for a total of 297,626 patient years.

Standardized incidence and mortality ratios were used to compare cancer incidence and mortality for patients on dialysis and transplant recipients during periods of graft function and graft failure with the Australian general population, according to the study.

Au noted a slight difference in cancer risk between different cancers. For cancers in which immunosuppression might have a greater effect, such as virus-associated cancers like cervical cancer or post-transplant lymphoproliferative disorder, Au reported a significant increase during episodes of immunosuppression.

Researchers found cancer incidence and mortality remained higher than the general population for patients with failed allografts, but the increased risk appeared lower than recipients with functioning grafts.

“That risk reduces after the kidney transplant fails in the first instance, and after they received the second transplant, immunosuppression risk increases again,” Au said. “But after the second transplant fails, the risk still seems to be elevated, which might be a reflection of the overall immunosuppression from previous years.”– by Kristine Houck, MA, ELS, and Joe Gramigna

Reference:

Au EHK, et al. Paper SA-PO050. Presented at: ASN Kidney Week; Oct. 23-28, 2018; San Diego.

Disclosure: Au reports no relevant financial disclosures.