Post-transplantation Malignancy After Kidney Transplantation in Turkey

Keleş, Yıldız Ekemen; Tekin, S.; Düzenli, Mehmet Akif; Yüksel, Yücel; Yücetin, L.; Döşemeci, L; Şengül, Ali; Demirbaş, A.; Tuncer, Murat

doi:10.1016/j.transproceed.2015.04.010

Cited by 9 publications

(8 citation statements)

References 17 publications

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“…In addition to immunosuppression and EBV status, young age, 6,8,10,14,15,17 Caucasian race, 8,10,13 recipient cytomegalovirus (CMV) seronegativity, [12][13][14]20,21 hepatitis C infections, 11 and human leukocyte antigen (HLA)-B mismatch 14 have also been identified as risk factors for developing PTLD. Although many risk factors have been identified, investigation of a large cohort of kidney transplant recipients with an extensive follow-up will further contribute to the optimization of clinical management.…”

Section: Introductionmentioning

confidence: 99%

Incidence, Risk Factors, Clinical Management, and Outcomes of Posttransplant Lymphoproliferative Disorder in Kidney Transplant Recipients

et al. 2019

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Background: Posttransplant lymphoproliferative disorder (PTLD) is a severe complication after kidney transplantation. This study examined the incidence, risk factors, clinical management, and outcomes of PTLD in a cohort of kidney transplant recipients. Design: This single-center cohort study included 1642 patients transplanted from January 1, 2000, to December 31, 2012, with follow-up until December 31, 2013. The incidence and risk factors for PTLD were examined using a Cox proportional hazards model. A Cox model was also used to assess the association of PTLD and graft outcomes. Results: Sixteen recipients developed PTLD over follow-up. The incidence rate was 0.18 (95% confidence interval [CI]: 0.11-0.29) cases per 100 person-years. Four were from Epstein-Barr virus (EBV) mismatched (Dþ/RÀ) transplants and 12 from EBV-positive recipients (Rþ). Recipients with Dþ/RÀ matches were at a significantly higher risk of developing PTLD than Rþ (hazard ratio [HR]: 7.52 [95% CI: 2.42-23.32]). Fifteen cases had immunosuppression reduced, 11 cases were supplemented with rituximab or ganciclovir, 6 cases required chemotherapy or radiation, and 6 cases had tumors excised. By the end of follow-up, 6 patients went into remission, 5 returned to chronic dialysis, and 5 patients died. Patients with PTLD were significantly more likely to have total graft failure (return to chronic dialysis, preemptive retransplant, or death with graft function) than patients without PTLD (HR: 3.41 [95% CI: 1.72-6.78). Discussion: Epstein-Barr virus mismatch continues to be a strong risk factor for developing PTLD after kidney transplantation. Recipients with PTLD have a poor prognosis, as the optimal management remains to be elucidated.

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Section: Introductionmentioning

confidence: 99%

Incidence, Risk Factors, Clinical Management, and Outcomes of Posttransplant Lymphoproliferative Disorder in Kidney Transplant Recipients

et al. 2019

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“…Twenty-nine eligible studies comprising a total of 36,021 renal transplant recipients were included in the current meta-analysis [ Figure 1 ]. [ 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 ] Of the 29 publications, 25 were used for estimating the incidence of NMSC[ 14 15 16 17 18 19 20 21 22 23 25 26 27 28 29 30 33 34 35 36 37 38 39 40 41 42 ] whereas 11 publications were included to estimate the incidence of SCC and BCC. [ 14 15 18 19 22 27 32 34 38 40 42 ] Basic characteristics of included studies are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Majority of included studies had been performed in Europe ( n = 19),[ 14 15 16 17 20 21 23 24 25 26 29 30 31 32 33 35 37 38 41 ] four in Australia and New Zealand,[ 18 19 28 34 ] three in Middle East,[ 36 40 42 ] and three in South Africa,[ 22 ] Brazil,[ 39 ] and Canada. [ 27 ] There were 16 retrospective cohort studies,[ 14 16 22 23 25 27 28 29 30 32 33 35 36 39 41 42 ] 12 prospective cohort studies.…”

Section: Resultsmentioning

confidence: 99%

“…[ 27 ] There were 16 retrospective cohort studies,[ 14 16 22 23 25 27 28 29 30 32 33 35 36 39 41 42 ] 12 prospective cohort studies. [ 17 18 19 20 21 24 26 31 34 37 38 40 ] The mean age at transplantation and follow-up period ranged from 37 to 52.2 and 1.5 to 27.75 years, respectively. A total number of 1948 subjects developed NMSC in selected studies [ Table 1 ].…”

Section: Resultsmentioning

confidence: 99%

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Incidence of nonmelanoma skin cancer in renal transplant recipients: A systematic review and meta-analysis

2018

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Background:Nonmelanoma skin cancer (NMSC) in renal transplant recipients is common and associated with significant morbidity and mortality. The aim of the present systematic review and meta-analysis was to estimate the incidence of NMSC among renal transplant recipients.Materials and Methods:We systematically searched PubMed, Medline, Scopus, and Web of Science databases for studies that assessed the incidence of NMSC in renal transplant recipients using a combination of relevant keywords. Two independent investigators included studies and extracted necessary information. Random effect meta-analysis was used to estimate pooled incidence of NMSC with 95% confidence intervals (CIs).Results:Twenty-nine studies comprising 36,021 patients meet the criteria for the systematic review. The pooled incidence of NMSC in renal transplant recipients was 12.6% (95% CI: 12%–14%) with a majority of squamous cell carcinoma (SCC) 55% (95% CI: 47%–63%). The pooled estimate of the incidence rates of SCC and basal cell carcinoma was 2.7% (95% CI: 2%–3.4%) and 2.2% (95% CI: 1.5%–2.8%), respectively. Subgroup analysis per geographic location showed that pooled incidence of NMSC was 39.1% (95% CI: 26.3%–51.8%), 12.4% (95% CI: 8.8%–16%), and 1.2% (95% CI: 0.4%–2%) in Australia and New Zealand, Europe, and Middle East, respectively.Conclusion:The results of the current meta-analysis demonstrated that the incidence of NMSC in renal transplant recipients varies widely. Regarding the high incidence of NMSC among renal transplant recipients, awareness of associated risk factors and early diagnosis of the malignancy in the population is a major clinical need.

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“…Thus, lung cancer that is frequent in the Croatian general population is rare in renal transplant population in our cohort of patients. Turkey has a very high prevalence of lung cancer among renal transplant recipients, while Croatia and China have low prevalence [7,8].…”

Section: Discussionmentioning

confidence: 99%

Lung Cancer in Renal Transplant Recipients

et al. 2016

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Introduction. Although the incidence of malignancy has increased after solid organ transplantation, data on lung cancer in this group of patients is scarce. The aim of this study was to determine clinical characteristics and outcome of patients who developed lung cancer after renal transplantation. Methods. Among a cohort of 1658 patients who received a transplant at our institution and were followedup between 1973 and 2014, five patients developed lung cancer. We analyzed risk factors, transplantation characteristics, treatment options and survival. Results. Lung cancer was diagnosed in 5 patients (0.3%). Time to diagnosis after the transplant procedure ranged from 26 to 156 months (mean 115 months). All of them had a smoking history. Tumors were classified as IIB (20%), IIIA (40%), and IV (40%). Histological types included adenocarcinoma (80%) and there was one case of sarcomatoid carcinoma (20%). One patient had concomitant thyroid papillary carcinoma. Radiotherapy was applied in 2 patients, 2 underwent chemotherapy (erlotinib and combination of carboplatinum and etopozide in one patient each), and 2 died within one month after the diagnosis from disseminated malignant disease. Patients with stage IIIA survived 14 and 24 months after the diagnosis. The patient with sarcomatoid cancer underwent thoracotomy with a complete resection, lost his graft function and died 7 months after the diagnosis. Conclusion. Lung cancer is relatively rare malignancy in renal transplant recipients, but associated with high mortality. Smoking is a significant risk factor, thus smoking cessation should be promoted among renal transplant recipients, as well as regular screening for lung cancer.

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Post-transplantation Malignancy After Kidney Transplantation in Turkey

Cited by 9 publications

References 17 publications

Incidence, Risk Factors, Clinical Management, and Outcomes of Posttransplant Lymphoproliferative Disorder in Kidney Transplant Recipients

Incidence, Risk Factors, Clinical Management, and Outcomes of Posttransplant Lymphoproliferative Disorder in Kidney Transplant Recipients

Incidence of nonmelanoma skin cancer in renal transplant recipients: A systematic review and meta-analysis

Lung Cancer in Renal Transplant Recipients

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