Influence of chronic kidney disease and other risk factors pre-heart transplantation on malignancy incidence post-heart transplantation

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Muhammed T. Gürgöze¹  Eric H. Boersma¹  Felix Zijlstra¹  Olivier C. Manintveld²  Stefan Roest²  Josef Stehlik³  Wida S. Cherikh⁴ 

[1] Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands;Department of Cardiology, Thorax Center, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands;Erasmus MC Transplant Institute, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands;Division, of Cardiovascular Medicine, U.T.A.H. Cardiac Transplant Program, University of Utah Health Salt Lake City, Utah, UT, United States;United Network for Organ Sharing, Richmond, VA, United States;

关键词: cancer;    heart transplantation;    malignancies;    chronic kidney disease;    death-adjusted incidence;   

DOI  :  10.3389/fcvm.2023.1145996

 received in 2023-01-16, accepted in 2023-03-06,  发布年份 2023

来源: Frontiers

【 摘 要 】

AimsChronic kidney disease (CKD) pre-heart transplantation (HTx) has been proposed as a risk factor for malignancy risk post-HTx. Using multicenter registry data, our aim was to calculate the death-adjusted annual incidence of malignancies post-HTx, corroborate the association between CKD pre-HTx and malignancy risk post-HTx, and determine other risk factors for post-HTx malignancies.Methods and materialsWe used data from patients transplanted in North American HTx centers between January 2000 and June 2017 and registered in the International Society for Heart and Lung Transplantation Thoracic Organ Transplant Registry. We excluded recipients with missing data on post-HTx malignancies, heterotopic heart transplant, retransplantation, multi-organ transplantation, and patients with a total artificial heart pre-HTx.ResultsOverall, 34,873 patients were included to determine the annual incidence of malignancies, 33,345 patients were included in the risk analyses. The incidence of any malignancy, solid-organ malignancy, post-transplant lymphoproliferative disease (PTLD), and skin cancer adjusted for death 15 years post-HTx, was 26.6%, 10.9%, 3.6%, and 15.8% respectively. Besides widely acknowledged risk factors, CKD stage ≥4 pre-HTx was associated with the development of all malignancies post-HTx (HR 1.17 compared to CKD stage 1, p = 0.023), as well as solid-organ malignancies (HR 1.35, p = 0.01), but not for PTLD (HR 0.73, p = 0.057), and skin cancer (HR 1.06, p = 0.59).ConclusionRisk of malignancy post-HTx remains high. CKD stages ≥4 pre-HTx was associated with an increased risk for any malignancy and solid-organ malignancy post-HTx. Strategies to mitigate the impact of pre-HTx patient factors on the risk of post-HTx malignancy are needed.

【 授权许可】

Unknown   
© 2023 Roest, Gürgöze, Cherikh, Stehlik, Boersma, Zijlstra and Manintveld.