Tumor Recurrence and Graft Survival in Renal Transplant Recipients with a History of Pretransplant Malignancy: A Matched Pair Analysis

Journal of Clinical Medicine

卷:10

Andreas Pascher¹  Felix Becker¹  Vasilios Getsopulos¹  JensG. Brockmann¹  Ralf Bahde¹  Anne-Sophie Mehdorn²  Barbara Suwelack³  Katharina Schütte-Nütgen³  Stefan Reuter³ 

[1] Department of General, Visceral and Transplant Surgery, University Hospital Münster, 48149 Münster, Germany;

[2] Department of General, Visceral, Transplantation, Thoracic and Pediatric Surgery, University Hospital Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany;

[3] Division of General Internal Medicine, Nephrology and Rheumatology, Department of Internal Medicine D, University Hospital Münster, 48149 Münster, Germany;

关键词: kidney transplantation;    graft survival;    oncological outcome;    waiting time;    cancer;   

DOI  :  10.3390/jcm10112349

来源: DOAJ

【 摘 要 】

Organ scarcity demands critical decision-making regarding eligible transplant candidates and graft allocation to ensure best benefit from renal transplantation (RTx). Among the controversial relative contraindications is a history of pretransplant malignancy (PTM). While oncological outcomes of PTM-RTx recipients are well described, data on graft-specific outcome are scarce. A retrospective double case control matched pair analysis (60 months follow-up) was carried out and RTx-recipients were stratified for history of PTM. First, PTM-RTx recipients were matched according to age, sex and duration of immunosuppressive therapy. Next, PTM-RTx recipients were matched 1:1 for age, sex and cause of end-stage renal disease. Five-year patient and graft survival as well as oncological outcomes were analyzed. A total of 65 PTM-RTx recipients were identified. Post-RTx recurrence rate was 5%, while 20% developed second de novo malignancy, comparable to 14% in the control group. PTM-RTx recipients had a noticeable lower five-year death-censored as well as overall graft survival and Cox proportional hazard modeling showed a correlation between PTM and inferior graft survival. Although underlying reasons remain not fully understood, this study is the first to show inferior graft survival in PTM-RTx recipients and advocates necessity to focus on more meticulous graft monitoring in PTM recipients in addition to heightened surveillance for cancer recurrence.

【 授权许可】

Unknown