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Kidney transplantation linked with increased risk of various cancers
December 20, 2006Following kidney transplantation, some recipients may face a 3-fold increased risk of certain cancer types, according to a study in the December 20 issue of JAMA.
Immune suppression after organ transplantation is associated with a markedly increased risk of nonmelanoma skin cancer, non-Hodgkin lymphoma, and Kaposi sarcoma. Whether other cancers occur at increased rates is uncertain, because there have been few long-term population-based studies, according to background information in the article.
Claire M. Vajdic, Ph.D., of the University of New South Wales, Sydney, Australia, and colleagues compared the incidence of cancer in 28,855 patients with end-stage kidney disease (ESKD) who received renal (kidney) replacement therapy (RRT). Data were collected for three separate time periods: the 5 years before RRT, during dialysis, and after transplantation. New cancers (1982-2003) were determined by record linkage between the Australia and New Zealand Dialysis and Transplant Registry and the Australian National Cancer Statistics Clearing House.
The researchers found that the overall incidence of cancer, excluding nonmelanoma skin cancer and those cancers known to frequently cause end-stage kidney disease, was markedly increased (3.27 times) after transplantation. In contrast, cancer incidence was only slightly increased (1.35 times) during dialysis and before RRT (1.16 times). After transplantation, cancer occurred at significantly increased incidence at 25 sites, and risk exceeded 3-fold at 18 of these sites.
"Although the incidence of some cancers was increased during dialysis, and the incidence of a few was increased before RRT, the magnitude and breadth of the increased risk after transplantation suggests that immune suppression causes a substantial and broad-ranging increase in cancer risk," the authors write.
"After kidney transplantation, a wide variety of cancers across a number of organ systems occur with substantially increased incidence. Most, but not all, of these cancers are those with known or suspected viral causes. In contrast, cancer incidence was only slightly increased before kidney transplantation. Our findings point to an important role of the interaction between common viral infections and the immune system in the etiology [cause] of cancers at a broad range of sites," the researchers conclude.
JAMA and Archives Journals
The researchers found that the overall incidence of cancer, excluding nonmelanoma skin cancer and those cancers known to frequently cause end-stage kidney disease, was markedly increased (3.27 times) after transplantation. In contrast, cancer incidence was only slightly increased (1.35 times) during dialysis and before RRT (1.16 times). After transplantation, cancer occurred at significantly increased incidence at 25 sites, and risk exceeded 3-fold at 18 of these sites.
"Although the incidence of some cancers was increased during dialysis, and the incidence of a few was increased before RRT, the magnitude and breadth of the increased risk after transplantation suggests that immune suppression causes a substantial and broad-ranging increase in cancer risk," the authors write.
"After kidney transplantation, a wide variety of cancers across a number of organ systems occur with substantially increased incidence. Most, but not all, of these cancers are those with known or suspected viral causes. In contrast, cancer incidence was only slightly increased before kidney transplantation. Our findings point to an important role of the interaction between common viral infections and the immune system in the etiology [cause] of cancers at a broad range of sites," the researchers conclude.
JAMA and Archives Journals
Kidney Transplantation Current Events and Kidney Transplantation News RSSSwitching immunosuppressants reduces cancer risk in kidney
Switching to a newer type of immunosuppressant drug may reduce the high rate of skin cancer after kidney transplantation, according to research being presented at the American Society of Nephrology's 42nd Annual Meeting and Scientific Exposition in San Diego, CA.
Older kidney transplant patients should more often consider live donors
Almost half of kidney transplant candidates older than 60 who are put on the waiting list for a deceased-donor organ will die before getting a transplant.
'Nature vs. nurture' study of deceased donor pairs in kidney transplantation
The implications of a new study could improve the outcomes, and potentially survival rates, for some of the thousands of individuals who undergo kidney transplants each year.
Kidney transplant survival can be long-term for people with HIV
A Johns Hopkins study finds that HIV-positive kidney transplant recipients could have the same one-year survival rates for themselves and their donor organs as those without HIV, provided certain risk factors for transplant failure are recognized and tightly managed.
African-American Canadians who receive kidney transplants fare better than those in US
African American kidney disease patients in both Canada and the United States are less likely than Caucasian Americans to have access to kidney transplants, but only African-Americans in the United States have worse health outcomes than Caucasians after a transplant is performed.
Study Shows Steroid Therapies Following Transplant Can Be Eliminated
A new study by researchers at UC shows that using modern immunosuppressive drugs eliminates the need for steroid therapy as early as seven days following a transplant surgery while still maintaining kidney function
Annual Report Targets Chronic Kidney Disease in the United States
A 30 percent increase in chronic kidney disease over the past decade has prompted the U.S. Renal Data System (USRDS) to issue for the first time a separate report documenting the magnitude of the disease, which affects an estimated 27 million Americans and accounts for more than 24 percent of Medicare costs.
New protocol streamlines therapy that makes more kidney transplants possible
A new therapy developed at Cedars-Sinai Medical Center improves transplant rates and outcomes for patients awaiting living- and deceased-donor kidney transplantation, according to a study published in the July 17 issue of the New England Journal of Medicine.
Anti-rejection drug may increase risk of diabetes after kidney transplant
For patients undergoing kidney transplantation, treatment with the anti-rejection drug sirolimus may lead to an increased risk of diabetes, reports a study in the July Journal of the American Society of Nephrology (JASN).
Race, insurance status affect access to transplantation and kidney disease treatment
Universal access to health care might help to overcome racial and ethnic barriers to treatment for kidney disease, suggest two studies in the March 2008 issue of Clinical Journal of the American Society of Nephrology.
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