Cancer After Liver Transplantation in Children and Young Adults: A Population‐Based Study From 4 Nordic Countries

Åberg, Fredrik; Isoniemi, Helena; Pukkala, Eero; Jalanko, Hannu; Rasmussen, Allan; Storm, Hans; Schultz, Nicolai Aagaard; Bennet, William; Ekvall, Nils; Ericzon, Bo Göran; Malenicka, Silvia; Tretli, Steinar; Line, Pål–Dag; Boberg, Kirsten Muri; Østensen, Anniken B.; Karlsen, Tom H.; Nordin, Arno

doi:10.1002/lt.25305

Cited by 14 publications

(16 citation statements)

References 23 publications

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“…Pharmacological immunosuppression (IS) remains one of the key modifiable factors influencing their long-term outcomes following liver transplantation (LT). Thus, after LT, the incidence of comorbidities such as chronic kidney disease, de novo malignancies, metabolic syndrome and cardiovascular diseases, all known to be negatively influenced by prolonged and/or excessive IS, gradually accumulates with time [1][2][3][4] . Numerous trials of IS withdrawal have now shown that a large proportion of long-term surviving LT recipients with stable allograft function and no significant histological abnormalities can substantially reduce their overall IS levels, and, in some cases, even completely discontinue IS 5 .…”

Section: Discussionmentioning

confidence: 99%

Non-invasive alloimmune risk stratification of long-term liver transplant recipients

Vionnet

Miquel

Abraldes

et al. 2021

Journal of Hepatology

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Section: Discussionmentioning

confidence: 99%

Non-invasive alloimmune risk stratification of long-term liver transplant recipients

Vionnet

Miquel

Abraldes

et al. 2021

Journal of Hepatology

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“…3,6 Five-year relative survival for children between 2009 and 2013 was 80% in the United States (USA). 7 Improved survival, however, means that a growing number of children have a lifelong increased risk of adverse health effects following treatment, notably hearing loss and cardiac toxicity associated with standard platinum-based liver cancer chemotherapy regimens, 8,9 substantial morbidity following liver transplantation for high-risk cases, 9,10 and late-effect adverse psychosocial outcomes. 8,11 The most common malignant liver tumour in younger children aged 0-4 years is embryonal tumour hepatoblastoma (HB).…”

Section: Introductionmentioning

confidence: 99%

Global trends in incidence rates of childhood liver cancers: A systematic review and meta‐analysis

Dasgupta

Henshaw

Youlden

et al. 2020

Paediatric Perinatal Epid

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Background Childhood liver cancers are relatively rare, hence inferences on incidence trends over time are limited by lack of precision in most studies. Objective To conduct a systematic review and meta‐analysis of published contemporary trends on childhood liver cancer incidence rates worldwide. Data sources PubMed, EMBASE, CINAHL, Web of Science. Study selection and data extraction English‐language peer‐reviewed articles published from 1 January 2008 to 1 December 2019 that presented quantitative estimates of incidence trends for childhood liver cancer and diagnostic subgroups. Review was conducted per PRISMA guidelines. Two authors independently extracted data and critically assessed studies. Synthesis Random effects meta‐analysis models were used to estimate pooled incidence trends by diagnostic subgroups. Heterogeneity was measured using the Q and I2 statistics and publication bias evaluated using Egger’s test. Results Eighteen studies were included, all based on population‐based cancer registries. Trends were reported on average for 18 years. Overall pooled estimates of the annual percentage change (APC) were 1.4 (95% confidence interval [CI] 0.5, 2.3) for childhood liver cancers, 2.8 (95% CI 1.8, 3.8) for hepatoblastoma and −3.0 (95% CI −11.0, 4.9) for hepatocellular carcinoma. Sub‐group analysis by region indicated increasing trends for childhood liver cancers in North America/Europe/Australia (APC 1.7, 95% CI 0.7, 2.8) whereas corresponding trends were stable in Asia (APC 1.4, 95%CI −0.3, 2.7). Publication bias was not detected for any of these analyses. The I2 statistic indicated that the heterogeneity among included studies was low for combined liver cancers, moderate for hepatoblastoma and high for hepatocellular carcinoma. Conclusions Incidence is increasing for childhood liver cancers and the most commonly diagnosed subgroup hepatoblastoma. Lack of knowledge of the etiology of childhood liver cancers limited the ability to understand the reasons for observed incidence trends. This review highlighted the need for ongoing monitoring of incidence trends and etiological studies.

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“…Like in the report from Australia and New Zealand, the majority of cancers were non-melanoma skin cancers [ 31 ]. Data from a long-term follow-up study on Nordic pediatric liver transplant patients showed that age is a significant risk factor for cancer, and the absolute risk for most cancers increases in patients older than 20 years of age [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

Cancer morbidity and mortality after pediatric solid organ transplantation—a nationwide register study

et al. 2020

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Background The prevalence of malignancies after pediatric solid organ transplantation was evaluated in a nationwide study. Methods All patients who had undergone kidney, liver, or heart transplantation during childhood between the years 1982 and 2015 in Finland were identified. The inclusion criteria were age under 16 years at transplantation and age over 18 years at the last follow-up day. A total of 233 (137 kidney, 53 liver, and 43 heart) transplant recipients were enrolled. Controls ( n = 1157) matched by the year of birth, gender, and hometown were identified using the Population Register Center registry. The cancer diagnoses were searched using the Finnish Cancer Registry. Results Altogether 26 individuals diagnosed with cancer were found, including 18 transplant recipients. Cancer was diagnosed at a median of 12.0 (IQR 7.8–17.8) years after the transplantation. The transplant recipients’ risk for cancer was significantly higher when compared with the controls (HR 14.7; 95% CI 6.4–33.9). There was no difference for different graft types. Sixty-one percent of cancers among the transplant recipients were diagnosed at age older than 18 years. Conclusion The risk for cancer is significantly higher among young adults having undergone solid organ transplantation during childhood in comparison with population controls. Careful follow-up and attention to prevent cancers throughout adulthood are warranted. Electronic supplementary material The online version of this article (10.1007/s00467-020-04546-y) contains supplementary material, which is available to authorized users.

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Cancer After Liver Transplantation in Children and Young Adults: A Population‐Based Study From 4 Nordic Countries

Cited by 14 publications

References 23 publications

Non-invasive alloimmune risk stratification of long-term liver transplant recipients

Non-invasive alloimmune risk stratification of long-term liver transplant recipients

Global trends in incidence rates of childhood liver cancers: A systematic review and meta‐analysis

Cancer morbidity and mortality after pediatric solid organ transplantation—a nationwide register study

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