Epidemiology of tumoral pathology in renal transplantation
Abstract
Introduction: Tumoral pathology (TP) implies morbidity which is significant after the renal transplantation; Immunosuppression is a risk factor which is potentially responsible for tumoral development. Objective: The aim of our study is to determine the prevalence of malignancy during transplantation and to study its possible relation with the usage of antillymphocvte antibodies, cytomegalovirus infection and the history of acute rejection. Methods: It is a cohort study, retrospective, in 1014 receptors of kidney transplantation in which tumoral events were revised between April 1981 and March 2010. The development of tumoral pathology in recipients was related with the usage of AAL, CMV infection and AR episodes. Results: a greater frequency of malign TP was no recorded in those who received AAL (13.8% vs. 17.6%, p=0.094). There was not greater frequency of TP in patients with infection due to CMV (16,3% vs, 15.2%, p=0.69). Finally, there was greater frequency of TP in those with antecedent of AR, though with bordering significance (19.5%, vs. 14.3% p=0.05). Conclusions: Malign tumoral pathology is potentially favored by immunosuppression increasingly powerful lasting. We have not found any relationship between AAL use, infection and/ or disease due to CMV, although this is slightly increased in those patients with AR history.References
Campistol JM. Minimizing the risk of posttransplant malignancy. Transplant Proc. 2008;40(10 Suppl):S40-3.
Gutiérrez-Dalmau A, Campistol JM. The role of proliferation signal inhibitors in post-transplant malignancies. Nephrol Dial Transplant. 2007;22(Suppl 1):i11-6.
Gutierrez-Dalmau A, Campistol JM. Immunosuppressive therapy and malignancy in organ transplant recipients: a systematic review. Drugs. 2007;67(8):1167-98.
Branco F, Cavadas V, Osório L, Carvalho F, Martins L, Dias L, et al. The incidence of cancer and potential role of sirolimus immunosuppression conversion on mortality among a single-center renal transplantation cohort of 1,816 patients. Transplant Proc. 2011;43(1):137-41.
Winkelhorst JT, Brokelman WJ, Tiggeler RG, Wobbes T. Incidence and clinical course of de-novo malignancies in renal allograft recipients. Eur J Surg Oncol. 2001;27(4):409-13.
Savoia P, Stroppiana E, Cavaliere G, Osella-Abate S, Mezza E, Segoloni GP, et al. Skin cancers and other cutaneous diseases in renal transplant recipients: a single Italian center observational study. Eur J Dermatol. 2011;21(2):242-7.
Roberts IS, Besarani D, Mason P, Turner G, Friend PJ, Newton R. Polyoma virus infection and urothelial carcinoma of the bladder following renal transplantation. Br J Cancer. 2008;99(9):1383-6.
Lutz J, Heemann U. Tumours after kidney transplantation. Curr Opin Urol. 2003;13(2):105-9.
Birkeland SA, Løkkegaard H, Storm HH. Cancer risk in patients on dialysis and after renal transplantation. Lancet. 2000;355(9218):1886-7.
Moudouni SM, Lakmichi A, Tligui M, Rafii A, Tchala K, Haab F, et al. Renal cell carcinoma of native kidney in renal transplant recipients. BJU Int. 2006;98(2):298-302.
Brook NR, Gibbons N, Johnson DW, Nicol DL. Outcomes of transplants from patients with small renal tumours, live unrelated donors and dialysis wait-listed patients. Transpl Int. 2010;23(5):476-83.
Fischereder M, Jauch KW. Prevalence of cancer history prior to renal transplantation. Transpl Int. 2005;18(7):779-84.
Campistol JM, Schena FP. Kaposi's sarcoma in renal transplant recipients--the impact of proliferation signal inhibitors. Nephrol Dial
Transplant. 2007 May;22(Suppl 1):i17-22.
Franco A, Jiménez L, Sillero C, Trigueros M, González D, Alcaraz E, et al. [Post-transplant lymphoproliferative disorders in renal
transplantation: two decades of experience]. Nefrologia. 2010;30(6):669-75.
Abbaszadeh S, Taheri S. Kaposi's sarcoma after renal transplantation. Saudi J Kidney Dis Transpl. 2009;20(5):775-8.
Filocamo MT, Zanazzi M, Li Marzi V, Guidoni L, Villari D, Dattolo E, et al. Renal cell carcinoma of native kidney after renal transplantation:
clinical relevance of early detection. Transplant Proc. 2009;41(10):4197-201.
Heynemann H, Hamza A, Wagner S, Hoda R, Schumann A, Fornara P. [Malignant neoplasms and kidney transplantation]. Urologe A. 2009;48(12):1443-51.
Trigo JM, Bellmunt J. [Current strategies in the treatment of renal-cell cancer: targeted therapies]. Med Clin (Barc). 2008;130(10):380-92.
Hurst FP, Jindal RM, Graham LJ, Falta EM, Elster EA, Stackhouse GB, et al. Incidence, predictors, costs, and outcome of renal cell carcinoma after kidney transplantation: USRDS experience. Transplantation. 2010;90(8):898-904.